In a randomized trial of patients with solid tumors, acupuncture significantly improved symptoms of chemotherapy-induced peripheral neuropathy (CIPN) compared with usual care (JAMA Netw Open. 2020;3[3]:e200681).

“[CIPN] is the most common and debilitating long-term adverse effect of neurotoxic chemotherapy that significantly worsens cancer survivors’ quality of life. Well-tolerated, evidence-based interventions for CIPN are needed,” explained Ting Bao, MD, DABMA, MS, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, and colleagues.

Thus, Dr Bao et al carried out a pilot study comparing the efficacy of 8 weeks of real versus sham acupuncture or usual care in patients with solid tumors and persistent moderate to severe CIPN who had ≥3 months of chemotherapy.

Between July 2017 and June 2018, a total of 75 patients (median age, 59.7 years) were enrolled in the study, including 40 (53%) patients with breast cancer and 12 (16%) with colorectal cancer.

Patients were randomized in a 1:1:1 ratio to receive real acupuncture (n = 24), sham acupuncture (n = 23), and usual care (ie, no interventions throughout the study period; n = 21).

The primary end point of the study was CIPN symptom severity, which was measured via numeric rating scale (NRS; 11-point scale; 0 = no symptoms and 10 = worst symptom imaginable) at week 8. Differences in temporal changes between treatment arms were assessed via mixed-effects models with an interaction term between group and assessment time (up to 8 weeks). A 2-sided P <.05 was set as the threshold for statistical significance.

At week 8, a significant decrease in NRS-measured pain, tingling, and numbness was observed in recipients of real acupuncture versus usual care. By week 8, the mean absolute reduction in CIPN pain was greatest with real acupuncture (−1.75; 95% CI, −2.69 to −0.81) and observed least in recipients of usual care (−0.19; 95% CI, −1.13 to 0.75).

Sham acupuncture had a reduction of −0.91 as of week 8 (95% CI, −2.0 to 0.18), and at 12 weeks, real acupuncture had a mean absolute reduction in NRS-measured pain of −1.74 (95% CI, −2.6 to −0.83) whereas sham acupuncture had a reduction of −0.34 (95% CI, −1.3 to 0.61).

According to Dr Bao and colleagues, adverse events were scarce and mild.

“In conclusion, compared with usual care, acupuncture resulted in significant improvement in CIPN symptoms,” they said.—Hina Porcelli