Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, largo Brambilla 3, 50134, Florence, Italy.
Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Florence, Italy.
Eur Arch Otorhinolaryngol. 2022 Apr;279(4):2083-2097. doi: 10.1007/s00405-021-07002-1. Epub 2021 Jul 31.
In head and neck squamous cell carcinoma (HNSCC), the potential mitigating effect of complementary medicine interventions such as acupuncture for radiation-induced toxicity is unknown. This study aimed to assess the impact of acupuncture on the incidence and degree of severity of common radiation-induced side effects.
In accordance with pre-specified PICO criteria, a systematic review was performed. Two electronic databases (Medline and Embase) were searched over a 10-year time frame (01/01/10 to 30/09/20). Patients undergoing a curatively intended, radiation-based treatment for histologically confirmed squamous cell carcinoma of the nasopharynx, oropharynx, larynx, hypopharynx and oral cavity represented the target population of our study. Accurate information on the acupuncture methodology was reported. All included articles were evaluated to identify any potential source of bias RESULTS: Five papers were included in our qualitative analysis, for a total of 633 subjects. Compliance to per-protocol defined schedule of acupuncture sessions was high, ranging from 82 to 95.9%. Most patients (70.6%) were randomly allocated to receive acupuncture for its potential preventive effect on xerostomia. The large heterogeneity in study settings and clinical outcomes prevented from performing a cumulative quantitative analysis, thus no definitive recommendations can be provided.
Although shown to be feasible and safe, no firm evidence currently supports the use of acupuncture for the routine management of radiation-induced toxicity in HNSCC.
在头颈部鳞状细胞癌（HNSCC）中，针灸等补充医学干预措施减轻放射性毒性的潜在作用尚不清楚。本研究旨在评估针灸对常见放射性副作用的发生率和严重程度的影响。
根据预先指定的 PICO 标准，进行了系统评价。在 10 年的时间范围内（2010 年 1 月 1 日至 2020 年 9 月 30 日），在两个电子数据库（Medline 和 Embase）中进行了搜索。本研究的目标人群是接受根治性、基于放射治疗的组织学证实的鼻咽癌、口咽癌、喉癌、下咽癌和口腔癌的患者。报告了有关针灸方法的准确信息。对所有纳入的文章进行评估，以确定任何潜在的偏倚来源。
我们的定性分析纳入了 5 篇论文，共 633 例患者。针灸方案的依从性很高，达到了 82%至 95.9%。大多数患者（70.6%）因针灸对口干症的潜在预防作用而被随机分配接受针灸治疗。由于研究环境和临床结局的高度异质性，无法进行累积的定量分析，因此无法提供明确的建议。
尽管针灸显示出可行性和安全性，但目前尚无确凿证据支持将其常规用于治疗 HNSCC 的放射性毒性。
