Garcia M Kay, Cohen Lorenzo, Guo Ying, Zhou Yuhong, You Bing, Chiang Joseph, Orlowski Robert Z, Weber Donna, Shah Jatin, Alexanian Raymond, Thomas Sheeba, Romaguera Jorge, Zhang Liang, Badillo Maria, Chen Yiming, Wei Qi, Lee Richard, Delasalle Kay, Green Vivian, Wang Michael
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 0429, Houston, Texas 77030, USA.
J Hematol Oncol. 2014 May 9;7:41. doi: 10.1186/1756-8722-7-41.
This single-arm study evaluated feasibility, safety, and initial efficacy of electroacupuncture for thalidomide/bortezomib-induced peripheral neuropathy (PN) in cancer patients with multiple myeloma.
Patients with neuropathy ≥ grade 2 received 20 acupuncture treatments over 9 weeks.
For the 19 evaluable patients, Functional Assessment of Cancer Therapy/Gynecological Oncology Group-Neurotoxicity (FACT/GOG/NTX) mean (SD) scores improved significantly between baseline and week 13 (20.8 [9.6] vs 13.2 [8.5], p = 0.0002). Moderate effect size differences began on week 4, with the largest effect size differences found at week 9 for FACT/GOG/NTX scores, worst pain in the last 24 hours, and pain severity (Cohen's d = 1.43, 1.19, and 1.08, respectively) and continuing through week 13 (Cohen's d = 0.86, 0.88, and 0.90, respectively). From baseline to week 13, additional significant improvements were seen as follows: postural stability (1.0 [0.6] vs 0.8 [0.4], p = 0.02); coin test (10.0 [7.4] vs 5.6 [1.9], p < 0.0001); button test (96.1 [144.4] vs 54.9 [47.3], p < 0.0001); and walking test (21.6 [10.0] vs 17.2 [7.7], p = 0.0003). No significant changes were seen with NCS.
Acupuncture may help patients experiencing thalidomide- or bortezomib-induced PN. Larger, randomized, clinical trials are needed.
ClinicalTrials.gov Identifier: NCT00891618.
这项单臂研究评估了电针治疗多发性骨髓瘤癌症患者中沙利度胺/硼替佐米引起的周围神经病变(PN)的可行性、安全性和初步疗效。
神经病变≥2级的患者在9周内接受20次针灸治疗。
对于19例可评估患者,癌症治疗功能评估/妇科肿瘤学组神经毒性(FACT/GOG/NTX)平均(标准差)评分在基线和第13周之间显著改善(20.8 [9.6] 对13.2 [8.5],p = 0.0002)。中等效应量差异在第4周开始出现,FACT/GOG/NTX评分、过去24小时内最严重疼痛和疼痛严重程度在第9周时效应量差异最大(Cohen's d分别为1.43、1.19和1.08),并持续至第13周(Cohen's d分别为0.86、0.88和0.90)。从基线到第13周,还观察到以下显著改善:姿势稳定性(1.0 [0.6] 对0.8 [0.4],p = 0.02);硬币试验(10.0 [7.4] 对5.6 [1.9],p < 0.0001);纽扣试验(96.1 [144.4] 对54.9 [47.3],p < 0.0001);以及步行试验(21.6 [10.0] 对17.2 [7.7],p = 0.0003)。神经传导速度检查未见显著变化。
针灸可能有助于治疗沙利度胺或硼替佐米引起的PN患者。需要开展更大规模的随机临床试验。
ClinicalTrials.gov标识符:NCT00891618。