Acupuncture For Cancer-related Fatigue Research Articles

Oncologia integrata in radioterapia: evidenze scientifiche e gestione degli effetti collaterali

Success of radiotherapy in eradicating a tumour depends principally on the total radiation given, but the tolerance of healthy tissues surrounding the tumour limits its dose. The clinical manifestations of either acute or late radiation toxicity can be quite severe. Complementary and integrative medicines have recently attracted the interest of researchers and medical practitioners since several trials showed some evidence about the benefi ts of using herbal medicine and acupuncture for cancer-related fatigue, nausea and vomiting, diarrhea, oncological pain, radiodermitis, mucositis, anxiety, and depression. There is also very good evidence for the effi cacy of sport/physical activity and nutrition in oncology, where a regular diet of vegetables is recommended. Physical activity is recommended also during chemo/radiotherapy for the reduction of treatment side effects. Dietary modifi cation such as caloric restriction has been shown to decrease tumour initiation and progression, and could be used during radiotherapy as a novel therapeutic intervention to enhance the cytotoxic effect on the tumour and reduce the cytotoxic effects on healthy tissue.

Acupuncture for cancer-related fatigue in lung cancer patients: a randomized, double blind, placebo-controlled pilot trial.

Cancer-related fatigue (CRF) is a distressing symptom that is the most common unpleasant side effect experienced by lung cancer patients and is challenging for clinical care workers to manage. We performed a randomized, double-blind, placebo-controlled pilot trial to evaluate the clinical effect of acupuncture on CRF in lung cancer patients. Twenty-eight patients presenting with CRF were randomly assigned to active acupuncture or placebo acupuncture groups to receive acupoint stimulation (LI-4, Ren-6, St-36, KI-3, and Sp-6) twice per week for 4weeks, followed by 2weeks of follow-up. The primary outcome was the change in intensity of CFR based on the Chinese version of the Brief Fatigue Inventory (BFI-C). As the secondary endpoint, the Functional Assessment of Cancer Therapy-Lung Cancer Subscale (FACT-LCS) was adopted to assess the influence of acupuncture on patients' quality of life (QOL). Adverse events and safety of treatments were monitored throughout the trial. Our pilot study demonstrated feasibility among patients with appropriate inclusion criteria and good compliance with acupuncture treatment. A significant reduction in the BFI-C score was observed at 2weeks in the 14 participants who received active acupuncture compared with those receiving the placebo (P<0.01). At week 6, symptoms further improved according to the BFI-C (P<0.001) and the FACT-LCS (P=0.002). There were no significant differences in the incidence of adverse events in either group (P>0.05). Fatigue is a common symptom experienced by lung cancer patients. Acupuncture may be a safe and feasible optional method for adjunctive treatment in cancer palliative care, and appropriately powered trials are warranted to evaluate the effects of acupuncture.

Training in self-needling and performing it as part of a clinical trial: the practitioner and patient experience.

To explore the experience of training and performing self-needling from both the practitioners' and patients' perspective. A qualitative study was conducted using focus groups and interviews, nested within our multi-site randomised controlled trial, Acupuncture for Cancer-Related Fatigue in Patients with Breast Cancer. Patients allocated to self-needling across two UK study sites and all therapists who were involved in the trial were invited to participate. The interviews/focus groups were then transcribed verbatim and analysed thematically by the process of content analysis. Of the 67 eligible patients, 8 (12%) contributed to the focus groups and 15 practitioners (100%), contributed to the study by either attending a focus group or being interviewed. Themes identified for patients included: the allocation to self-needling, teaching techniques and practical considerations and whether they would self-needle again. Themes identified for practitioners included: views on self-needling, teaching self-needling and future implications of self-needling. Self-needling was found to be acceptable to, and manageable by, patients, and enthusiastically adopted by most practitioners. Methods of teaching self-needling need to be developed and evaluated with guidelines recommended for best practice.

PC-FACS

PC-FACS

Acupuncture for cancer-related fatigue: a systematic review of randomized clinical trials

Managing cancer-related fatigue (CRF) is an important element of the palliative care of cancer patients. The aim of this systematic review was to critically evaluate the effectiveness of acupuncture (AT) or electroacupuncture (EA) for CRF. Fourteen databases were searched from their respective inception to November 2012. Randomized clinical trials (RCTs) of AT or EA for the treatment of CRF were considered for inclusion. The risk of bias/methodological quality was assessed using the method suggested by the Cochrane Collaboration. Seven RCTs met the eligibility criteria. Most were small pilot studies with serious methodological flaws. Four of the RCTs showed effectiveness of AT or AT in addition to usual care (UC) over sham AT, UC, enhanced UC, or no intervention for alleviating CRF. Three RCTs showed no effect of AT/EA over sham treatment. Overall, the quantity and quality of RCTs included in the analysis were too low to draw meaningful conclusions. Even in the positive trials, it remained unclear whether the observed outcome was due to specific effects of AT/EA or nonspecific effects of care. Further research is required to investigate whether AT/EA demonstrates specific effects on CRF.