Acupuncture for Chemotherapy-Induced Peripheral Neuropathy


Chemotherapy-induced peripheral neuropathy (CIPN), which can lead to permanent symptoms and disability in up to 40% of cancer survivors. CIPN can be a significant disability following the treatment of many types of cancer, including breast, colorectal, testicular, and hematological malignancies, and have an impact on quality of life.


So far, chemo medications such as Taxanes, Oxaliplatin, Cisplatin, Vincristine, Thalidomide, and Bortezomib have been reported to induce peripheral neuropathy. As for treatment, there are currently no therapies with a confirmed neuroprotective benefit available for clinical use in patients with CIPN.


Fortunately, acupuncture works very well for CIPN. For example, in a randomized controlled pilot trial acupuncture for chemotherapy‐induced peripheral neuropathy in breast cancer survivors, which was performed at the Department of Medical Oncology, Dana‐Farber Cancer Institute, Harvard University. In this trial, women with stage I–III breast cancer with grade 1 or higher CIPN after taxane‐containing adjuvant chemotherapy were randomized 1:1 to an immediate acupuncture (IA) arm or to a waitlist control group (CG). Participants in the IA arm received 18 sessions of acupuncture over 8 weeks, then received no additional acupuncture. Patients in the CG arm received usual care over 8 weeks, followed by nine sessions of acupuncture over 8 weeks. Measures including Patient Neurotoxicity Questionnaire (PNQ), Functional Assessment of Cancer Therapy—Neurotoxicity subscale (FACT‐NTX), and Brief Pain Inventory—short form (BPI‐SF) were collected at baseline and at 4, 8, and 16 weeks after enrollment.


They found that forty women (median age, 54) were enrolled (20 to IA and 20 to CG), with median time between completion of chemotherapy and enrollment of 14 months (range 1–92). At 8 weeks, participants in the IA arm experienced significant improvements in PNQ sensory score (−1.0 ± 0.9 vs. −0.3 ± 0.6; p = .01), FACT‐NTX summary score (8.7 ± 8.9 vs. 1.2 ± 5.4; p = .002), and BPI‐SF pain severity score (−1.1 ± 1.7 vs. 0.3 ± 1.5; p = .03), compared with those in the CG arm. No serious side effects were observed.


Thus, their conclusion is: women with CIPN after adjuvant taxane therapy for breast cancer experienced significant improvements in neuropathic symptoms from an 8‐week acupuncture treatment regimen.


Our clinic has good experience for neuropathy. We emphasize using some special technique to induce strong local “De-Qi” sensation.


References:


1. Susanna B Park 1, David Goldstein, Arun V Krishnan, Cindy S-Y Lin, Michael L Friedlander, James Cassidy, Martin Koltzenburg, Matthew C Kiernan. Chemotherapy-induced peripheral neurotoxicity: a critical analysis. CA Cancer J Clin. Nov-Dec 2013;63(6):419-37. doi: 10.3322/caac.21204.

https://acsjournals.onlinelibrary.wiley.com/doi/pdfdirect/10.3322/caac.21204


2. Weidong Lu, Anita Giobbie‐Hurder, Rachel A. Freedman, Im Hee Shin, Nancy U. Lin, Ann H. Partridge, David S. Rosenthal, and Jennifer A. Ligibel. Acupuncture for Chemotherapy‐Induced Peripheral Neuropathy in Breast Cancer Survivors: A Randomized Controlled Pilot Trial. Oncologist. 2020 Apr; 25(4): 310–318. doi: 10.1634/theoncologist.2019-0489

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160396/


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