[Electroacupuncture for the prevention of chemotherapy-induced peripheral neuropathy: a randomized controlled trial].

OBJECTIVE

To investigate the clinical effect of electroacupuncture (EA) in preventing chemotherapy-induced peripheral neuropathy (CIPN).

METHODS

Fifty-two patients with breast cancer in the regimen of taxane-assisted/neoadjuvant chemotherapy, were randomly divided into an EA group (26 cases, 3 cases dropped out) and a usual care (UC) group (26 cases, 1 case dropped out). In the UC group, on the basis of standard chemotherapy regimen, the routine nursing was administered. In the EA group, on the intervention as the UC group, EA was added, the acupoints included Yintang (GV 24), Baxie (EX-UE 9, the second one), Waiguan (TE 5), Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36), Yinlingquan (SP 9), Sanyinjiao (SP 6), Taixi (KI 3), Taichong (LR 3), Xuanzhong (GB 39) and Bafeng (EX-LE 10, the fourth one). Electric stimulation was attached to Taichong (LR 3) and Sanyinjiao (SP 6) on the same side, with disperse-dense wave and the frequency of 2 Hz/10 Hz, for 30 min. EA started one day before the first cycle of chemotherapy, twice weekly in the first two weeks and once weekly in the rest weeks of chemotherapy. The duration of the intervention with EA was 12 weeks. The incidence of CIPN was compared in week 24 of the trial between the two groups. At the baseline and in week 12 and 24 of the trial, the score of EORTC QLQ-CIPN20 (European Organization for Research and Treatment of Cancer on chemotherapy-induced peripheral nerve toxicity quality of life questionnaire 20), the score of TCM syndrome scale and the score of EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer on quality of life scale) were observed in the two groups. At the baseline and in week 12 of the trial, the sensory nerve conduction velocity (SCV) and the motor nerve conduction velocity (MCV) was detected.

RESULTS

In week 24 of the trial, the incidence of CIPN was 17.4% (4/23) in the EA group, lower than that (72.0%, 18/25) in the UC group (<0.001). The incidence of high-grade CIPN was 0% (0/23) in the EA group, lower than that (28.0%, 7/25) in the UC group (<0.05). In week 12 and 24 of the trial, the scores for the sensory nerve symptom of EORTC QLQ-CIPN20 and the total scores were higher when compared with the baseline in the UC group (<0.001, <0.05, <0.01). In week 24 of the trial, the score for the sensory nerve symptom of EORTC QLQ-CIPN20 in the EA group was lower than that of the UC group (<0.05). In week 12 of the trial, SCV of the right superficial peroneal nerve was reduced when compared with the baseline in the UC group (<0.05), and SCV of the left median nerve and the right superficial peroneal nerve was higher in the EA group when compared with the UC group (<0.05, <0.01). In week 12 and 24 of the trial, the scores for the secondary symptoms of TCM scale were decreased in the EA group compared with the baseline (<0.05), and the scores for the primary and secondary symptoms, as well as the total scores of TCM scale were all higher than those of the baseline in the UC group (<0.01, <0.001, <0.05). In week 12 of the trial, the scores for the primary and secondary symptoms, as well as the total score of TCM scale in the EA group were lower than those of the UC group (<0.05, <0.01). In week 24 of the trial, the score for the secondary symptoms and the total score of TCM scale in the EA group were lower than those of the UC group (<0.05). In week 12 of the trial, the scores for fatigue, pain, nausea and vomiting in EORTC QLQ-C30 were increased in comparison with the baseline in the UC group (<0.05, <0.01); in week 24 of the trial, the score of the general health in EORTC QLQ-C30 was elevated when compared with the baseline in the EA group (<0.001), and the scores for nausea and vomiting, loss of appetite were decreased in comparison with the baseline (<0.01). In week 12 of the trial, the score of the general health in EORTC QLQ-C30 in the EA group was higher compared with the UC group (<0.01), and the scores for pain, nausea and vomiting were lower (<0.01, <0.05). In week 24 of the trial, the score of the general health in EORTC QLQ-C30 was higher in the EA group compared with the UC group (<0.001), and the score for loss of appetite was lower (<0.05).

CONCLUSION

Electroacupuncture reduces the incidence and severity of CIPN, ameliorates nerve conduction velocity and improves the quality of life of the patients.