Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, 44 Binney St., Boston, MA 02115, USA.
Integr Cancer Ther. 2010 Jun;9(2):158-67. doi: 10.1177/1534735409360666.
Acupuncture is underutilized as an adjunct cancer therapy. The main study objectives were to determine the feasibility of administering acupuncture as palliative therapy to patients with advanced ovarian or breast cancer and to assess the effect on symptoms and quality of life (QOL).
This study was a pilot, single-armed prospective clinical trial for patients with advanced cancer to receive 12 acupuncture sessions over 8 weeks with follow-up at weeks 9 and 12. Ambulatory patients with advanced ovarian or breast cancer were enrolled to receive treatments at an outpatient academic oncology center. Symptom severity was measured before and after each acupuncture session.A composite QOL assessment tool, consisting of validated instruments, was completed at 5 time points.
Forty patients enrolled in the study. Twenty-eight patients (70%; 95% confidence interval [CI] = 53%-83%) completed 4 weeks of treatment, and 26 patients (65%; 95% CI = 48%-79%) completed 8 weeks. Eight patients (20%) withdrew before receiving acupuncture, and 6 patients (15%) discontinued treatment early because of disease progression or scheduling demands. Among all 32 assessed patients, there was self-reported improvement immediately post-treatment in anxiety,fatigue, pain, and depression and significant improvement over time for patients with anxiety (P = .001) and depression(P = .02). Among patients experiencing baseline symptoms, there was improvement in anxiety (P = .001), fatigue (P = .0002),pain (P = .0002), and depression (P = .003). QOL measures of pain severity and interference, physical and psychological distress, life satisfaction, and mood states showed improved scores during treatment, with sustained benefit at 12 weeks.
This pilot study demonstrates that an 8-week outpatient acupuncture course is feasible for advanced cancer patients and produces a measurable benefit that should be evaluated in controlled trials.
针灸作为癌症辅助疗法的应用不足。主要研究目的是确定为晚期卵巢癌或乳腺癌患者提供针灸姑息治疗的可行性,并评估对症状和生活质量(QOL)的影响。
这是一项针对晚期癌症患者的前瞻性单臂临床试验,这些患者在 8 周内接受 12 次针灸治疗,并在第 9 周和第 12 周进行随访。在学术肿瘤中心的门诊招募有晚期卵巢癌或乳腺癌的门诊患者接受治疗。在每次针灸治疗前后测量症状严重程度。采用由经过验证的工具组成的综合 QOL 评估工具,在 5 个时间点进行评估。
该研究共纳入 40 例患者。28 例患者(70%;95%置信区间[CI] = 53%-83%)完成了 4 周的治疗,26 例患者(65%;95% CI = 48%-79%)完成了 8 周的治疗。8 例患者(20%)在接受针灸治疗前退出,6 例患者(15%)因疾病进展或时间安排要求提前停止治疗。在所有 32 例接受评估的患者中,治疗后焦虑、疲劳、疼痛和抑郁的自我报告均有改善,且患者的焦虑(P =.001)和抑郁(P =.02)随时间推移有显著改善。在有基线症状的患者中,焦虑(P =.001)、疲劳(P =.0002)、疼痛(P =.0002)和抑郁(P =.003)均有改善。疼痛严重程度和干扰、身体和心理困扰、生活满意度和情绪状态的 QOL 测量指标在治疗过程中显示出改善的评分,并在 12 周时仍具有获益。
这项初步研究表明,为期 8 周的门诊针灸课程对于晚期癌症患者是可行的,并且产生了可衡量的益处,值得在对照试验中进行评估。