University of Maryland Greenebaum Cancer Center, Baltimore, Maryland.
Cancer. 2014 Feb 1;120(3):381-9. doi: 10.1002/cncr.28352. Epub 2013 Dec 23.
Aromatase inhibitors (AIs) have been associated with decrements in patient-reported outcomes (PROs). The objective of this study was to assess whether real acupuncture (RA), compared with sham acupuncture (SA), improves PROs in patients with breast cancer who are receiving an adjuvant AI.
Postmenopausal women with a stage 0 through III breast cancer who received an AI and had treatment-associated musculoskeletal symptoms were randomized to receive 8 weekly RA versus SA in a dual-center, randomized controlled trial. The National Surgical Adjuvant Breast and Bowel Project (NSABP) menopausal symptoms questionnaire, the Center for Epidemiological Studies Depression (CESD) scale, the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), the hot flash daily diary, the Hot Flash-Related Daily Interference Scale (HFRDI), and the European quality-of-life survey (EuroQol) were used to assess PROs at baseline and at 4weeks, 8 weeks, and 12 weeks.
The intention-to-treat analysis included 23 patients in the RA arm and 24 patients in the SA arm. There were no significant differences in baseline characteristics between the 2 groups. Compared with baseline, scores in the RA arm improved significantly at week 8 on the CESD (P = .022), hot flash severity (P = .006), hot flash frequency (P = .011), the HFRDI (P = .014), and NSABP menopausal symptoms (P = .022); scores in the SA arm improved significantly on the EuroQol (P = .022),the HFRDI (P = .043), and NSABP menopausal symptoms (P = .005). Post-hoc analysis indicated that African American patients (n = 9) benefited more from RA than SA compared with non-African American patients (n = 38) in reducing hot flash severity (P < .001) and frequency (P < .001) scores.
Both RA and SA were associated with improvement in PROs among patients with breast cancer who were receiving AIs, and no significant difference was detected between arms. Racial differences in response to acupuncture warrant further study.
芳香化酶抑制剂（AIs）已被证实与患者报告的结局（PROs）下降有关。本研究的目的是评估与假针刺（SA）相比，真实针刺（RA）是否能改善接受辅助 AI 治疗的乳腺癌患者的 PROs。
接受 AI 治疗且有治疗相关肌肉骨骼症状的绝经后 0 至 III 期乳腺癌患者被随机分配至双中心、随机对照试验中，每周接受 8 次 RA 或 SA。采用国家外科辅助乳腺和肠道项目（NSABP）绝经症状问卷、流行病学研究抑郁量表（CESD）、医院焦虑和抑郁量表（HADS）、匹兹堡睡眠质量指数（PSQI）、每日潮热日记、潮热相关日常干扰量表（HFRDI）和欧洲生活质量调查（EuroQol）在基线和 4 周、8 周和 12 周评估 PROs。
意向治疗分析包括 RA 组 23 例患者和 SA 组 24 例患者。两组患者基线特征无显著差异。与基线相比，RA 组在第 8 周时 CESD（P = .022）、潮热严重程度（P = .006）、潮热频率（P = .011）、HFRDI（P = .014）和 NSABP 绝经症状（P = .022）得分显著改善；SA 组在 EuroQol（P = .022）、HFRDI（P = .043）和 NSABP 绝经症状（P = .005）得分显著改善。事后分析表明，与非非洲裔美国患者（n = 38）相比，非洲裔美国患者（n = 9）接受 RA 治疗时，潮热严重程度（P < .001）和频率（P < .001）得分的降低幅度更大。
RA 和 SA 均与接受 AI 治疗的乳腺癌患者的 PROs 改善相关，两组间无显著差异。针刺反应的种族差异需要进一步研究。
