Acupuncture for Quality of Life in Gastric Cancer Patients Undergoing Adjuvant Chemotherapy

Yan-Juan Zhu; Xiao-Yu Wu; Wei Wang; Xue-Song Chang; Dan-Dan Zhan; De-Chang Diao; Jian Xiao; Yong Li; Dong Ma; Ming Hu; Jian-Chang Li; Jin Wan; Guan-Nan Wu; Chuan-Feng Ke; Kai-Yu Sun; Zhi-Liang Huang; Tai-Yuan Cao; Xiao-Hui Zhai; Ya-Dong Chen; Jian-Jun Peng; Jun J Mao; Hai-Bo Zhang

doi:10.1016/j.jpainsymman.2021.09.009

Acupuncture for Quality of Life in Gastric Cancer Patients Undergoing Adjuvant Chemotherapy

J Pain Symptom Manage. 2022 Feb;63(2):210-220. doi: 10.1016/j.jpainsymman.2021.09.009. Epub 2021 Sep 23.

Authors

Yan-Juan Zhu¹, Xiao-Yu Wu², Wei Wang³, Xue-Song Chang⁴, Dan-Dan Zhan⁴, De-Chang Diao³, Jian Xiao⁵, Yong Li⁶, Dong Ma⁷, Ming Hu⁸, Jian-Chang Li⁹, Jin Wan³, Guan-Nan Wu², Chuan-Feng Ke⁸, Kai-Yu Sun¹⁰, Zhi-Liang Huang⁹, Tai-Yuan Cao⁵, Xiao-Hui Zhai⁵, Ya-Dong Chen⁴, Jian-Jun Peng¹¹, Jun J Mao¹², Hai-Bo Zhang¹³

Affiliations

¹ Department of Oncology (Y.J.Z., X.S.C., D.D.Z., Y.D.C., H.B.Z.), Guangdong Provincial Hospital of Traditional Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome (Y.J.Z., H.B.Z.), Guangzhou, China; Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research (Y.J.Z., H.B.Z.), Guangzhou University of Chinese Medicine, Guangzhou, China.
² Gastrointestinal Surgery (X.Y.W., G.N.W.), Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China.
³ Gastrointestinal Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine (W.W., D.C.D., J.W.), the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
⁴ Department of Oncology (Y.J.Z., X.S.C., D.D.Z., Y.D.C., H.B.Z.), Guangdong Provincial Hospital of Traditional Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
⁵ Medical Oncology, the Sixth Affiliated Hospital (J.X., T.Y.C., X.H.Z.), Sun Yat-sen University, Guangzhou, China.
⁶ Gastrointestinal Surgery (Y.L.), Guangdong Provincial People's Hospital, Guangzhou, China.
⁷ Gastrointestinal Oncology (D.M.), Guangdong Provincial People's Hospital, Guangzhou, China.
⁸ Gastrointestinal Surgery (M.H., C.F.K.), the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
⁹ Gastrointestinal Surgery (J.C.L., Z.L.H.), Cancer Center of Guangzhou Medical University, Guangzhou, China.
¹⁰ Gastrointestinal Surgery (K.U.S., J.J.P.), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
¹¹ Gastrointestinal Surgery (K.U.S., J.J.P.), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: [email protected].
¹² Department of Medicine (J.J.M.), Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: [email protected].
¹³ Department of Oncology (Y.J.Z., X.S.C., D.D.Z., Y.D.C., H.B.Z.), Guangdong Provincial Hospital of Traditional Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome (Y.J.Z., H.B.Z.), Guangzhou, China; Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research (Y.J.Z., H.B.Z.), Guangzhou University of Chinese Medicine, Guangzhou, China; State Key Laboratory of Dampness Syndrome of Chinese Medicine (H.B.Z.), the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou China. Electronic address: [email protected].

Abstract

Context: Patients with gastric cancer experience health-related quality of life (HRQOL) decline during adjuvant chemotherapy following gastrectomy.

Objectives: This pilot study aimed to evaluate the preliminary effect and feasibility of electro-acupuncture (EA) for HRQOL and symptom burden in these patients.

Methods: In this open-label, multicenter, parallel controlled trial, gastric cancer patients who planned to receive adjuvant chemotherapy were randomly assigned to receive high-dose EA (seven times each chemotherapy cycle for three cycles), low-dose EA (three times each chemotherapy cycle), or usual care only. The acupoints prescription consisted of bilateral ST36, PC6, SP4, and DU20, EX-HN3, and selected Back-shu points. Patients completed the Functional Assessment of Cancer Therapy-Gastric (FACT-Ga) weekly, and the Edmonton Symptom Assessment System (ESAS). The primary outcome was the difference among the groups on the gastric cancer subscale (GaCS) of the FACT-Ga.

Results: Of the 66 randomized patients, 58 were analyzed according to intention-to-treat principle, and 45 were in the per-protocol set (PPS). The average scores in PPS of GaCS were 52.12±9.71, 51.85±12.36, and 45.37±8.61 in high-dose EA, low-dose EA, and control groups, respectively. EA was significantly associated with improved average GaCS scores when compared with control group (51.98±10.91 vs. 45.37±8.61, P = 0.039). EA treatment also produced ESAS relief at the end of intervention (14.36 ± 12.28 vs. 23.91 ± 15.52, P = 0.027). Participants in EA groups had fewer grade ≥3 leukopenia (0% vs. 15.79%, P = 0.031) and neutropenia (2.56% vs. 26.31%, P = 0.012).

Conclusion: EA showed promising effects in improving HRQOL, controlling symptom burden, and reducing toxicity during adjuvant chemotherapy in gastric cancer patients. Future adequately powered trials are feasible and needed to confirm the specific effect of EA.

Keywords: Acupuncture; adjuvant chemotherapy; gastric cancer; health-related quality of life; symptom burden.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Acupuncture Therapy*
Chemotherapy, Adjuvant
Humans
Pilot Projects
Quality of Life
Stomach Neoplasms* / drug therapy

Grants and funding

P30 CA008748/CA/NCI NIH HHS/United States