Abstract

BackgroundChemotherapy-induced nausea and vomiting (CINV) is a common and distressing side effect. We conducted this clinical trial to compare the effectiveness of true acupuncture vs. sham acupuncture in controlling chemotherapy-induced nausea and vomiting (CINV) among patients with advanced cancer.MethodsA total of 134 participants were randomly allocated into true acupuncture (TA) (n = 68) and sham acupuncture (SA) (n = 66) groups. Participants in both groups received acupuncture session twice on the first day of chemotherapy, and once consecutively on the following 4 days. The primary outcome was using the Common Terminology Criteria for Adverse Events (CTCAE) to assess CINV. The secondary outcome measures were the Eastern Cooperative Oncology Group score (ECOG), Simplified Nutritional Appetite Questionnaire (SNAQ), and Hospital Anxiety and Depression scale (HADS).ResultsCompared to the SA group, the TA group didn’t show significant improvement in complete response rates of chemotherapy-induced nausea and vomiting (all P > 0.05). However, the TA group could modestly reduce the severity of nausea (from day-3 to day-21, P < 0.05) or vomiting (from day-4 to day-21, P < 0.05), which is notably superior to the control group. Besides, TA promoted the nutritional status of patients with a significantly higher score comparing to the SA group on day 14 (21.82 vs.20.12, P = 0.003) and day 21 (22.39 vs. 20.43, P = 0.001). No apparent differences were found in anxiety and depression assessment between these groups. Participants in both groups were well tolerant of acupuncture therapy. There was no adverse event occurs in our study.ConclusionAcupuncture as an adjunctive approach could alleviate the severity of chemotherapy-induced nausea and vomiting compared to the sham control, even though the effect of acupuncture in preventing CINV occurring is relatively modest.

Highlights

  • Chemotherapy-induced nausea and vomiting (CINV) is a common and distressing side effect

  • It could be speculated that the complete response rate of CINV by the standard antiemetic medications in clinical practice is lower than what is reported in the literature

  • Between March 2015 to July 2017, 158 eligible patients were enrolled from Beijing Shijitan Hospital, Beijing Friendship Hospital, Beijing Hospital of Traditional Chinese Medicine, and Guang’ Anmen Hospital

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Summary

Introduction

Chemotherapy-induced nausea and vomiting (CINV) is a common and distressing side effect We conducted this clinical trial to compare the effectiveness of true acupuncture vs sham acupuncture in controlling chemotherapy-induced nausea and vomiting (CINV) among patients with advanced cancer. Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and debilitating side effects which exerts a detrimental influence on the quality of life (QOL) of cancer patients and reduces their compliance towards conventional therapies. A phase 3 trial reported this combination therapy achieved a complete response rate of 79% in the patients who were receiving the first circle of cisplatin-based chemotherapy [3]. This result was based on only a single circle of chemotherapy with cisplatin. Emesis could be prevented well in most cases, nausea mainly occurring in delay-phase remains a significant challenge for cancer patients [4, 8, 9]

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