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10-07-2024 | Breast Cancer | Editor's Choice | News

Acupuncture reduces side effects of breast cancer treatment

Author: Dr. Shreeya Nanda

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medwireNews: Acupuncture could help ease hot flashes and other endocrine symptoms in women undergoing endocrine therapy (ET) for breast cancer, suggests a pooled analysis of three parallel, randomized trials.

The 10-week course of acupuncture “led to statistically and clinically meaningful improvements” relative to control, report Weidong Lu (Dana‐Farber Cancer Institute, Boston, Massachusetts, USA) and co-workers in Cancer.

They enrolled 158 women with stage 0–III hormone receptor-positive breast cancer through three parallel trials conducted in the USA (n=78), China (n=40), and South Korea (n=40). Participants were required to be on adjuvant ET treatment for at least 4 weeks and report having persistent hot flashes for at least 4 weeks.

The median age of the participants was 48 years and most were Asian (53.0%) or White (40.0%). The most used ET was tamoxifen, in 61.4%, and the average number of hot flashes at baseline was 6.3 per day.

The patients were randomly assigned to either immediate acupuncture, involving a standardized acupuncture protocol of two 30-minute sessions per week for 10 weeks alongside usual care, or to delayed acupuncture, which involved usual care for 10 weeks followed by 10 weeks of acupuncture using the same protocol but just one session a week.

At week 10, the improvement in the endocrine symptom subscale (ESS) of the Functional Assessment of Cancer Therapy (FACT)–Endocrine Symptoms questionnaire was significantly greater in the immediate than delayed acupuncture arm, at a mean increase of 5.1 versus 0.2 points.

Women who received immediate acupuncture experienced a significantly greater average reduction in the hot flash score at week 10 than those who received delayed acupuncture, at 5.3 versus 1.4 points. And a significantly higher proportion reported a reduction of at least 50% in the hot flash score, at 64% versus 18%.

Acupuncture was also associated with significant improvements in breast cancer‐specific quality of life as assessed by the FACT–B questionnaire. Total scores increased by a mean of 8.0 points in the immediate acupuncture group and 0.01 points in the control group.

Interestingly, ESS scores did not change significantly between weeks 10 and 20 in the immediate acupuncture group, suggesting that “the effects of acupuncture persisted for at least 10 weeks after the intervention in enrolled patients,” comment the researchers.

On the other hand, control participants, who started receiving reduced-intensity acupuncture after week 10, reported a significant increase in the ESS score and decrease in the hot flash score at week 20 relative to week 10, at means of 3.9 and 3.7 points, respectively.

Lu and colleagues highlight the limitations of the study, such as the use of delayed acupuncture as a control rather than using an active control condition, and the lack of Black and Hispanic participants in the study population.

They also note that the effect of the acupuncture intervention varied significantly by site, with the greatest benefit on the ESS score observed in South Korea, followed by the USA and China.

“There were differences in the implementation of the protocol intervention across sites, such as points, needle sizes, and devices selections, which may partially explain our observed site differences,” write the researchers.

And they conclude: “Additional trials are needed to evaluate the effect of acupuncture on hot flashes in more racially and ethnically diverse populations of patients with breast cancer and to determine whether improvements in hot flashes translate into better medication adherence, increasing the likelihood that acupuncture not only could help patients feel better during ET but also may help to improve cancer‐related outcomes in women with breast cancer.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2024 Springer Healthcare Ltd, part of the Springer Nature Group

Cancer 2024; doi:10.1002/cncr.35374

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