Acupuncture improves chemotherapy-induced neuropathy explored by neurophysiological and clinical outcomes - The randomized, controlled, cross-over ACUCIN trial.
Study Goal
The researchers were attempting to determine the effects of acupuncture on chemotherapy-induced peripheral neuropathy (CIPN), not Walking.
Results Summary
The study found that acupuncture improved structural regeneration in CIPN, as measured by nerve conduction studies, and led to subjective improvements in symptoms like burning pain, cramps, numbness, and gait unsteadiness.
Population
Sixty patients with chemotherapy-induced peripheral neuropathy (CIPN).
Effective Dosage
Not applicable (study focused on acupuncture, not Walking).
Duration
10-week treatment period with follow-ups at 14 and 28 weeks.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
acupuncture | increase | sural sensory nerve amplitude | patients with CIPN | p < 0.01, effect size (f) 0.55 | significantly improved | #1 |
acupuncture | increase | sural nerve conduction velocity | patients with CIPN | p < 0.01, effect size (f) 0.49 | significantly improved | #2 |
acupuncture | no change | NCS of the tibial nerve | patients with CIPN | - | did not significantly differ | #3 |
acupuncture | decrease | burning pain | patients with CIPN | p < 0.01 | subjective improvement | #4 |
acupuncture | decrease | cramps | patients with CIPN | p < 0.01 | subjective improvement | #5 |
acupuncture | decrease | numbness | patients with CIPN | p < 0.01 | subjective improvement | #6 |
acupuncture | decrease | frequency of symptoms | patients with CIPN | p < 0.01 | subjective improvement | #7 |
acupuncture | decrease | unsteadiness of gait | patients with CIPN | p < 0.05 | subjective improvement | #8 |
acupuncture | increase | blind walking | patients with CIPN | p < 0.01 | significantly improved | #9 |
acupuncture | increase | heel-to-toe walking | patients with CIPN | p < 0.01 | significantly improved | #10 |
acupuncture | increase | distal pallhypesthesia | patients with CIPN | p < 0.01 | significantly improved | #11 |
acupuncture | increase | neuropathy deficit score | patients with CIPN | p < 0.05 | significantly improved | #12 |
acupuncture | increase | CIPN as measured by NCS | patients with CIPN | - | can enhance structural regeneration | #13 |
BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is recognized as the second commonest side effect after chemotherapy. Besides neurological deficits and pain, it is a potential reason for terminating chemotherapy. Effective curative treatments of neurodegeneration are lacking. Hitherto, no randomized controlled study used nerve conduction studies (NCS), the gold standard diagnostic tool for peripheral neuropathy, as the primary outcome parameter for evaluating acupuncture for CIPN, which can also measure structural changes. METHODS: The study was carried out at the HanseMerkur Center for TCM at the University Medical Center, Hamburg-Eppendorf. Sixty patients with CIPN were included in the study after physical examination, subjective evaluation and quantitative evaluation by NCS. Subsequently, the patients were randomly assigned to Group 1 (30 patients), which received, in the first period, needle acupuncture and to Group 2 (30 patients), which was assigned to the waiting list in the first period. Group 1 received a standard 10-week bilateral treatment of ST34 (Liangqiu), EX-LE12 (Qiduan) and EX-LE8 (Bafeng). After 14 weeks, both groups were re-evaluated. Using a cross-over design, the patients of Group 2 received the same treatment procedure as Group 1 in the first period. Patients of Group 1 were assigned to the waiting list for the second period. After 28 weeks both groups were re-evaluated. Wilcoxon test was used as a pre-test to rule out carryover effects and to test for differences between acupuncture and the waiting list. Group assignment was not exposed to the statistician and the neurologist. RESULTS: Sural sensory nerve amplitude, and sural nerve conduction velocity, were significantly improved (p < 0.01, effect size (f) 0.55 and 0.49) compared to measurements in the waiting period. Change of NCS of the tibial nerve did not significantly differ in group comparison. Patients reported subjective improvement during acupuncture treatment superior to the waiting period for burning pain, cramps, numbness, frequency of symptoms (all p < 0.01) and unsteadiness of gait (p < 0.05). On physical examination, blind walking, heel-to-toe walking, distal pallhypesthesia (both p < 0.01), and the neuropathy deficit score (p < 0.05) were significantly improved during acupuncture treatment compared to the waiting period. CONCLUSION: Acupuncture can enhance structural regeneration in CIPN as measured by NCS, which is manifested in subjective improvement and neurological findings.