D'Alessandro Eduardo Guilherme, Nebuloni Nagy Daniela Ribeiro, de Brito Christina May Moran, Almeida Elisangela Pinto Marinho, Battistella Linamara Rizzo, Cecatto Rebeca Boltes
Instituto do Cancer, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brasil.
Rehabilitation Department, Instituto do Cancer, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.
BMJ Support Palliat Care. 2022 Mar;12(1):64-72. doi: 10.1136/bmjspcare-2018-001542. Epub 2019 Jun 29.
Chemotherapy-induced peripheral neuropathy (CIPN) can cause loss of independence and poor quality of life (QoL) due to severe disabilities, but in spite of its importance there is still a lack of data for the management of CIPN. Acupuncture has showed promising results and may be a cost-effective option for the treatment.
To evaluate the effect of acupuncture treatment on neurological symptoms of CIPN and QoL of oncological patients.
We performed a clinical, single-centre, randomised and controlled pilot study that involved 33 adult patients with cancer and CIPN randomised into two groups (control and acupuncture treated with 10 sessions, two times per week). Both groups were subjected to a complete physical examination and clinical assessment with National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Scale V.2.0, FIM Scale, European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC QLQ-C30) Scale and Visual Analogue Scale for pain before and 5 weeks after treatment.
There were no adverse events, and we found statistical differences in groups in physical (p=0.03) and function (p=0.04) domains of EORTC QLQ-C30 when comparing control and acupuncture groups. About NCI CTCAE Scale and neuropathy sensory symptoms, we found better results in acupuncture group, comparing pretreatment and post-treatment analyses (p=0.01). In control group, we have no differences after 5 weeks (p=0.11).
Although these results suggest an interesting effect of acupuncture on this patient population, the clinical significance has remained unclear. Given the tendency towards benefit and the lack of adverse effects, the authors recommend a follow-up acupuncture trial using higher follow-up time and better sample size.
NCT02309164.
化疗引起的周围神经病变（CIPN）可导致严重残疾，使患者失去自理能力并降低生活质量（QoL），尽管其影响重大，但目前仍缺乏CIPN管理方面的数据。针灸已显示出有前景的效果，可能是一种具有成本效益的治疗选择。
评估针灸治疗对CIPN神经症状及肿瘤患者生活质量的影响。
我们进行了一项临床、单中心、随机对照的试点研究，纳入33例患有癌症和CIPN的成年患者，随机分为两组（对照组和接受10次针灸治疗组，每周两次）。两组患者在治疗前和治疗后5周均接受全面体格检查，并使用美国国立癌症研究所不良事件通用术语标准（NCI CTCAE）V.2.0版量表、功能独立性测量（FIM）量表、欧洲癌症研究与治疗组织生活质量问卷核心量表（EORTC QLQ-C30）以及疼痛视觉模拟量表进行临床评估。
未出现不良事件，比较对照组和针灸组时，我们发现EORTC QLQ-C30量表的身体（p = 0.03）和功能（p = 0.04）领域在两组间存在统计学差异。关于NCI CTCAE量表和神经病变感觉症状，比较治疗前和治疗后的分析发现，针灸组效果更好（p = 0.01）。在对照组中，5周后无差异（p = 0.11）。
尽管这些结果表明针灸对该患者群体有显著效果，但其临床意义仍不明确。鉴于其有益趋势且无不良反应，作者建议开展一项随访时间更长、样本量更大的针灸试验。
NCT02309164。
