Acupuncture May Help to Prevent Chemotherapy-Induced Peripheral Neuropathy: A Randomized, Sham-Controlled, Single-Blind Study

Abstract

Objective: This study investigated the efficacy of acupuncture in preventing chemotherapy-induced peripheral neuropathy (CIPN) in patients with colorectal cancer (CRC).

Methods: This single center, randomized, controlled, single-blind clinical trial randomly assigned patients with stage 3 CRC attending outpatient clinics in China Medical University Hospital to either verum or sham acupuncture treatment concurrently with chemotherapy. Primary outcomes were nerve conduction velocity (NCV) and touch thresholds of limb terminals. Secondary outcomes were total and subdomain scores on the Functional Assessment of Cancer Therapy-General (FACT-G), and scores on the FACT/GOG-Ntx subscale and the Brief Pain Inventory-Short Form (BPI-SF), at baseline, weeks 12, 36, and follow-up (week 48).

Results: Thirty-two patients met the inclusion criteria and received verum acupuncture (N = 16) or sham acupuncture (N = 16). Under the -intent-to-treat principle, 26 participants were analyzed. Significant changes from baseline for questionnaire scores and sensory NCV were observed in both study groups. Sham acupuncture was associated with significant reductions from baseline in motor NCV and sensory touch thresholds; no such changes were observed with verum acupuncture. No serious adverse events were reported.

Conclusion: Prophylactic acupuncture may exert neuroprotective effects on mechanical or tactile touch thresholds during chemotherapy regimens in patients with CRC, with evidence of this protectiveness persisting at 6 months' follow-up. The lack of change in motor NCV values with verum acupuncture indicates neuroprotective effects. Sensory NCV values and patient-reported outcomes did not differ significantly between the study groups.

Keywords: acupuncture; chemotherapy; colorectal cancer; oxaliplatin; peripheral neuropathy; prevention.

Figure 1.

Flow diagram of the study participants.

Figure 2.

Changes from baseline for both acupuncture study groups at visits 3 (week 24), 4 (week 36), and 5 (week 48) in the median subdomain scores for FACT-G (a) Physical well-being, (b) social/family well-being, (c) emotional well-being, (d) functional well-being, (e) neurotoxicity, and (f) total scores. *P < .05; **P < .01.

Figure 3.

Changes from baseline for both acupuncture study groups at visits 3 (week 24), 4 (week 36), and 5 (week 48) in median motor conduction velocities of (a) the left median nerve, (b) right median nerve, (c) left ulnar nerve, (d) right ulnar nerve, (e) left tibial nerve, (f) right tibial nerve, (g) left peroneal nerve, and (h) right peroneal nerve. *P < .05; **P < .01.

Figure 4.

Changes from baseline for both acupuncture study groups at visits 3 (week 24), 4 (week 36), and 5 (week 48) in median sensory conduction velocities of (a) the left median nerve, (b) right median nerve, (c) left ulnar nerve, (d) right ulnar nerve, (e) left radial nerve, (f) right radial nerve, (g) left sural nerve, and (h) right sural nerve. *P < .05; **P < .01.

Figure 5.

Mean changes from baseline for both acupuncture groups at visits 3 (week 24), 4 (week 36), and 5 (week 48) in von Frey monofilament test values for (a) the left 1st, 2nd, and 3rd fingers, (b) right 1st, 2nd, and 3rd fingers, (c) left 5th finger, (d) right 5th finger, (e) left 1st and 2nd toes, (f) right 1st and 2nd toes, (g) left 4th and 5th toes, and (h) right 4th and 5th toes. *P < .05; **P < .01.