Acupuncture prevents radiation-induced dry mouth

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Acupuncture reduces the frequency and severity of xerostomia (dry mouth). Researchers at the MD Anderson Cancer Center at the University of Texas (Houston) and the Fudan University Cancer Center (Shanghai) conducted a randomized controlled clinical trial. The phase three blind patient and rater study on the effects of acupuncture on head and neck cancer patients receiving radiation therapy has shown groundbreaking results. The researchers concluded that acupuncture “resulted in significantly less and less severe RIX. [radiation-induced xerostomia] symptoms 1 year after treatment vs SCC [standard care control]. ” [1]

The salivary glands can be temporarily or permanently damaged by radiation therapy. There is a high incidence of RIX, which can cause complications, including difficult or painful swallowing, altered sense of taste (dysgeusia), and dental problems. Other RIX complications can include insomnia and difficulty speaking.

The study compared real acupuncture, sham acupuncture, and standard care control groups. True acupuncture produced significantly higher positive results for patients than other groups. Outcome measures were based on questionnaire, salivary flow, incidence of xerostomia, saliva content, and quality of life scores. One year after completing all acupuncture treatments, the real acupuncture group maintained significantly higher patient outcome rates than the standard and sham care groups.

All acupuncture treatments were performed by accredited acupuncturists. The researchers note that their findings are consistent with several previous surveys. True acupuncture patients who received acupuncture three times per week during their six to seven weeks of radiation therapy had significantly less dry mouth one year after completing treatment than standard care control patients. No adverse effects occurred at the University of Texas MD Anderson. One side effect was reported on the Fudan study site.

Researchers find that acupuncture is superior to standard care for the relief of radiation-induced xerostomia. They comment that acupuncture is “minimally invasive” and “has a very low incidence of adverse effects”. [2] Based on the evidence, further research is warranted.

All study participants were at least 18 years of age, provided informed consent, had a diagnosis of head and neck carcinoma, and were scheduled to undergo radiation therapy at an average dose of 24 Gy to at least one gland. parotid. A long list of exclusion criteria was used to prevent variables created by comorbidity.

All acupuncturists providing treatment during the study were licensed and were prepared and trained at the University of Texas MD Anderson Cancer Center. The acupuncture point prescription chosen for the study was as follows:

  • CV24
  • LU7
  • KD6
  • Little finger: Shenmen, Point Zero, Salivary gland 2 Prime, Larynx

Standard needle depths were used and the triggering of deqi at acupuncture points was at the discretion of the attending acupuncturists. In particular, once the deqi was obtained, the needles were no longer manually stimulated (except for the needles that were moved). Electroacupuncture was not used at any time.

The body style acupuncture needles were 0.25mm in diameter and 40mm in length. The auricular acupuncture needles had a diameter of 0.16 and a length of 15 mm. Acupuncture treatments were given a total of three times per week for the duration of the radiotherapy period of 6 to 7 weeks.

The researchers chose to avoid the use of local points other than CV24 in an attempt to prevent disruption of radiation damaged tissue. All patients were treated on the day of radiation therapy in a semi-upper position or supine position. Acupuncture has been performed before or after radiation therapy. Based on the data, the researchers note that acupuncture “should be considered for the prevention of radiation-induced xerostomia.” [3]

Investigators note that previous research indicates that acupuncture regulates blood flow to the parotid glands. Additionally, a variety of other studies have found acupuncture to be effective for the treatment of xerostomia. One of the studies cited in the survey found that acupuncture was effective for up to three years after treatment. Two pilot studies conducted by the research group prior to this phase three clinical trial found acupuncture to be effective in preventing RIX when combined with radiation therapy.

The study used strict controls, and the researchers monitored treatment facilities and licensed acupuncturists during the investigation. Further research will help support the standardization of acupuncture protocols for the prevention and treatment of RIX for inpatients and outpatients.

The references:
1. Garcia, MK, Meng, Z., Rosenthal, DI, Shen, Y., Chambers, M., Yang, P., Wei, Q., Hu, C., Wu, C., Bei, W. and Prinsloo, S., 2019. Effect of true and sham acupuncture on radiation-induced xerostomia in patients with head and neck cancer: a randomized clinical trial. Open JAMA Network, 2 (12), pp.e1916910-e1916910.
2. Idem.
3. Idem.

Continuing education credits in acupuncture

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