Tuesday, 02 April 2019 09:55

Acupuncture for Chemotherapy-Induced Peripheral Neuropathy (CIPN) in Breast Cancer: ACU-CIPN a pilot study - Carlo Giovanardi

Chemotherapy-induced peripheral  neuropathy(CIPN). Taxane-induced CIPN is a frequent side-effect, observed in 15–60% of breast cancer patients. It can produce severe neurological deficits and neuropathic pain and it is a potential reason for interrupting or reducing the dose of chemotherapy. Specific and effective treatments are lacking.

We conducted a multicentric pilot study to assess the feasibility, safety and preliminary effect of acupuncture for taxane-based CIPN in breast cancer.

Materials and methods
From October 2017 untill January 2018 we enrolled 9 patients, with breast cancer who were experiencing CIPN (I-III grade)  after the completion of a taxane neoadjuvant chemotherapy for at least 1 week.All of these have completed an informed consent.
Patients received 12 sessions of acupuncture over 6 weeks:EORTC QLQ–CIPN20 was assessed at baseline, after 3 weeks of treatment, at the end of the treatment and after 3 weeks of follow-up.NRS was assessed at baseline,before every session of acupuncture and after 3 weeks from the end of the treatment. We also registered side effects and every change in other symptoms affected the quality of life reported at the baseline.

At this time 4 patients completed the sessions and the follow up(44,4%). We analysed their data, using the Friedman-test for multiple comparison. CIPN-20 improved, with no statistical significance, from the baseline (T0) to the end of the treatment (T2) and also at follow-up (T3) for all the scales: sensory ( T1: 19,00±6,683, T2: 13,75±4,425, T3: 13,75 4,425,  p=0,142), motor (T1:11,50±3,317, T2: 10,25±1,708, T3: 10,75± 2,5 p= 0,392), autonomic (T0:2,75±1,5 T2: 2,25±0,5,  T3: 2,25±0,5 p= 0,572).The percentage of the improvement is 25% for sensory scale and 5,5% for motor scale at follow-up.We assessed a significant improvement of the NRS scale (p=0.001) that is maintained at follow-up.No side effects occurred. We also registered improvement/resolution of fatigue, insomnia, hot flashes, muscle cramps, peptic disorders: however these data were not statistically analyzed.

These preliminary data suggest that acupuncture is a feasible and safe treatment for CIPN in breast cancer patients. Although the sample analyzed is very small, the results show that acupuncture can significantly improve the subjective perception of pain; acupuncture seems also to have an impact in reducing CIPN-related symptoms. Further and large studies are needed to confirm these results.

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