medwire newsAcupuncture may help relieve hot flashes and other endocrine symptoms in women undergoing endocrine therapy (ET) for breast cancer, according to a pooled analysis of three parallel randomized trials.
Ten weeks of acupuncture treatment “led to statistically and clinically meaningful improvements” compared with the control group, report Weidong Lu (Dana-Farber Cancer Institute, Boston, Massachusetts) and colleagues. cancer.
Researchers enrolled 158 women with stages 0-III hormone receptor-positive breast cancer across three parallel trials conducted in the United States (n=78), China (n=40), and South Korea (n=40). Participants were required to have received at least 4 weeks of adjuvant ET treatment and report having at least 4 weeks of persistent hot flashes.
The mean age of participants was 48 years, and most were Asian (53.0%) or Caucasian (40.0%). The most commonly used ET was tamoxifen, 61.4%. The mean number of hot flashes at baseline was 6.3 per day.
Patients were randomly assigned to receive either immediate acupuncture, which involved a standardized acupuncture protocol of 30 minutes of acupuncture twice a week for 10 weeks alongside usual care, or delayed acupuncture, which involved 10 weeks of usual care followed by 10 weeks of weekly acupuncture with the same protocol.
At week 10, improvement in the Endocrine Symptoms Subscale (ESS) of the Functional Assessment of Cancer Therapy (FACT)–Endocrine Symptoms Questionnaire was significantly greater in the immediate acupuncture group than in the delayed acupuncture group, with a mean increase of 5.1 points versus 0.2 points.
Women who received immediate acupuncture had a significantly higher mean reduction in hot flash scores at week 10 (5.3 points) than women who received delayed acupuncture compared with 1.4 points for those who received delayed acupuncture. Also, the proportion of women who reported a 50% or greater reduction in hot flash scores was significantly higher (64% vs. 18% of women who received delayed acupuncture) compared with 1.4 points for those who received delayed acupuncture.
Acupuncture was also associated with a significant improvement in breast cancer-specific quality of life as assessed by the FACT-B questionnaire: the total score increased by a mean of 8.0 points in the immediate acupuncture group and 0.01 points in the control group.
Interestingly, in the immediate acupuncture group, ESS scores did not change significantly between weeks 10 and 20, suggesting that “the benefits of acupuncture persisted for at least 10 weeks after intervention in enrolled patients,” the researchers commented.
In contrast, control group participants who began receiving less intense acupuncture treatment after week 10 reported significantly increased ESS scores and decreased hot flash scores at week 20 compared to week 10, by an average of 3.9 points and 3.7 points, respectively.
Lu and her colleagues highlight limitations of their study, including the use of delayed acupuncture as a control rather than an active control condition and the lack of black or Hispanic participants in the study population.
They also noted that the effects of the acupuncture intervention varied widely by location, with the greatest effect on ESS scores observed in South Korea, followed by the United States and China.
“There may have been variations in implementation of protocol interventions across centers, including point, needle size, and device choice, which may partially explain the between-center differences we observed,” the researchers wrote.
The researchers concluded: “Additional studies are needed to evaluate the effect of acupuncture on hot flashes in more racially and ethnically diverse breast cancer patient populations and to determine whether improvement in hot flashes translates into better medication adherence, raising the possibility that acupuncture may not only help patients feel better during ET but also help improve cancer-related outcomes in women with breast cancer.”
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cancer 2024; doi:10.1002/cncr.35374
