Randomized controlled trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma

Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Cancer (Impact Factor: 4.89). 07/2012; 118(13):3337-44. DOI: 10.1002/cncr.26550
Source: PubMed


Xerostomia (dry mouth) after head/neck radiation is a common problem among cancer patients, and available treatments are of little benefit. The objective of this trial was to determine whether acupuncture can prevent xerostomia among head/neck patients undergoing radiotherapy.
A randomized, controlled trial among patients with nasopharyngeal carcinoma was conducted comparing acupuncture to standard care. Participants were treated at Fudan University Shanghai Cancer Center, Shanghai, China. Forty patients were randomized to acupuncture treatment and 46 to standard care. Patients were treated 3×/wk on the same days they received radiotherapy. Subjective measures included the Xerostomia Questionnaire and MD Anderson Symptom Inventory-Head and Neck (MDASI-HN). Objective measures were unstimulated and stimulated whole salivary flow rates. Patients were followed for 6 months after the end of radiotherapy.
Xerostomia Questionnaire scores for acupuncture were statistically significantly lower than for controls starting in week 3 through the 6 months (P = .003 at week 3, all other P < .0001), with clinically significant differences as follows: week 11, relative risk (RR) 0.63 (95% confidence interval [CI], 0.45-0.87); 6 months, RR 0.38 (95% CI, 0.19-0.76). Similar findings were seen for MDASI-HN scores. Group differences emerged as early as 3 weeks into treatment for saliva (unstimulated whole salivary flow rate, P = .0004), with greater saliva flow in the acupuncture group at week 7 (unstimulated whole salivary flow rate, P < .0001; stimulated whole salivary flow rate, P = .002) and 11 (unstimulated whole salivary flow rate, P < .02; stimulated whole salivary flow rate, P < .03) and at 6 months (stimulated whole salivary flow rate, P < .003).
Acupuncture given concurrently with radiotherapy significantly reduced xerostomia and improved quality of life.

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    • "Our study also found that almost half of the patients had no knowledge of acupuncture, and that any knowledge of acupuncture was associated with twice the likelihood of willingness to use acupuncture. As more evidence emerges regarding the use of acupuncture in the oncology setting [16] [24], it is critically important to disseminate such knowledge to patients and providers because there is a correlation between the degree to which patients are informed and their use of CAM [21]. With this information, patients and providers can make informed decisions about incorporating acupuncture into care with the goals of managing symptoms and improving quality of life. "
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