The Feasibility and Effects of Acupuncture on Quality of Life Scores During Chemotherapy in Ovarian Cancer: Results from a Pilot, Randomized Sham-Controlled Trial

Abstract

Background: Within a pilot trial regarding chemotherapy-induced neutropenia, the secondary aim of the main study was explored. This involved measuring the effects-as shown on two key measurement scales reflecting quality of life (QoL)-of verum versus sham acupuncture on patients with ovarian cancer during chemotherapy.

Objective: The aim of this substudy was to determine the feasibility of determining the effects of verum acupuncture versus sham acupuncture on QoL in patients with ovarian cancer during chemotherapy.

Design: This was a randomized, sham-controlled trial.

Setting: The trial was conducted at two cancer centers.

Patients: Patients with ovarian cancer (N=21) who were receiving chemotherapy-primarily intravenous carboplatin and paclitaxel-participated in this substudy.

Intervention: The participants were given either active or sham acupuncture 1 week prior to cycle 2 of chemotherapy. There were ten sessions of acupuncture, with manual and electro-stimulation over a 4-week period.

Main outcome measures: The European Organization for Research and Treatment of Cancer-Quality-of-Life Questionnaire-Core 30 Item (EORTC-QLQ-C30) and the Quality of Life Questionnaire-Ovarian Cancer Module-28 Item (QLQ-OV28) were administered to the patients at baseline and at the end of their acupuncture sessions.

Results: Of the original 21, 15 patients (71%) completed the study, and 93% of them completed the questionnaires. The EORTC-QLQ-C30 subscores were improved in the acupuncture arm, including the mean scores of social function (SF), pain, and insomnia (p=0.05). However, after adjusting for baseline differences, only the SF score was significantly higher in the active acupuncture arm, compared with the sham acupuncture arm (p=0.03).

Conclusions: It appears feasible to conduct a randomized sham-controlled acupuncture trial measuring QoL for patients with ovarian cancer who are undergoing chemotherapy. Acupuncture may have a role in improving QoL during chemotherapy.

Keywords: Acupuncture; Chemotherapy; EORTC; Neutropenia; Ovarian Cancer; Quality of Life; Randomized Controlled Trial.

FIG. 1.

Study schema outlining a 21-day cycle of chemotherapy and timing of acupuncture treatment. Black downward arrows, active acupuncture treatments; white upward arrows, sham acupuncture treatments; black horizontal line, verum (study) arm; dashed horizontal line, sham arm. Wk, week; chemo, chemotherapy.

FIG. 2.

(A) Active acupuncture protocols, treatment setup and technical specifications: acupuncture needle size, 0.20×25 mm (Vinco,® Helio Medical Supplies, Inc.); needling depth: 10 mm; De Qi requirement, Yes; electroacupuncture (EA) model, AWQ-104L (Mayfair Medical Supplies Ltd., Hong Kong); TDP infrared heat lamp, 30 cm above the feet; and needle retaining and stimulating duration, 30 minutes. Open dots indicate location on the medial side; closed dots indicate location at the front. (B) Sham acupuncture protocols, treatment setup and technical specifications: Acupuncture needle size, 0.12×30 mm (Seirin,® Seirin Corporation, Japan); needling depths: <0.2 mm; De Qi sensation prohibited, no needle manipulations; electroacupuncture model, deactivated AWQ-104 L; TDP infrared heat lamp, 75 cm above the feet; needle retaining and stimulating duration, 30 minutes. Shadowed box indicates inactive EA. Open dots indicate location on the medial side; closed dots indicate location at the front; shadowed dots indicate location on the lateral side.