Tuesday, 02 April 2019 09:55

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

Background
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.

Aim
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.

Results
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.

Conclusion
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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