Electroacupuncture for thalidomide/bortezomib-induced peripheral neuropathy in multiple myeloma: a feasibility study

Journal of Hematology & Oncology

Michael Wang²  Vivian Green²  Kay Delasalle²  Richard Lee³  Qi Wei³  Yiming Chen²  Maria Badillo²  Liang Zhang²  Jorge Romaguera²  Sheeba Thomas²  Raymond Alexanian²  Jatin Shah²  Donna Weber²  Robert Z Orlowski⁴  Joseph Chiang¹  Bing You⁷  Yuhong Zhou⁵  Ying Guo⁶  Lorenzo Cohen³  M Kay Garcia³ 

[1] Department of Anesthesiology & Peri-Operative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 0409, Houston, Texas 77030, USA;Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 0429, Houston, Texas 77030, USA;Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 0462, Houston, Texas 77030, USA;Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA;Department of Medical Oncology, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, P.R. China;Department of Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1414, Houston, Texas 77030, USA;American College of Acupuncture and Oriental Medicine, 9100 Park West Drive, Houston, Texas 77063, USA

关键词: Integrative medicine;    Peripheral neuropathy;    Chemotherapy;    Myeloma;    Acupuncture;   

Others  :  801042
DOI  :  10.1186/1756-8722-7-41

 received in 2013-11-14, accepted in 2014-04-09,  发布年份 2014

【 摘 要 】

Background

This single-arm study evaluated feasibility, safety, and initial efficacy of electroacupuncture for thalidomide/bortezomib-induced peripheral neuropathy (PN) in cancer patients with multiple myeloma.

Methods

Patients with neuropathy ≥ grade 2 received 20 acupuncture treatments over 9 weeks.

Results

For the 19 evaluable patients, Functional Assessment of Cancer Therapy/Gynecological Oncology Group-Neurotoxicity (FACT/GOG/NTX) mean (SD) scores improved significantly between baseline and week 13 (20.8 [9.6] vs 13.2 [8.5], p = 0.0002). Moderate effect size differences began on week 4, with the largest effect size differences found at week 9 for FACT/GOG/NTX scores, worst pain in the last 24 hours, and pain severity (Cohen’s d = 1.43, 1.19, and 1.08, respectively) and continuing through week 13 (Cohen’s d = 0.86, 0.88, and 0.90, respectively). From baseline to week 13, additional significant improvements were seen as follows: postural stability (1.0 [0.6] vs 0.8 [0.4], p = 0.02); coin test (10.0 [7.4] vs 5.6 [1.9], p < 0.0001); button test (96.1 [144.4] vs 54.9 [47.3], p < 0.0001); and walking test (21.6 [10.0] vs 17.2 [7.7], p = 0.0003). No significant changes were seen with NCS.

Conclusions

Acupuncture may help patients experiencing thalidomide- or bortezomib-induced PN. Larger, randomized, clinical trials are needed.

Trial registration

ClinicalTrials.gov Identifier: NCT00891618.

【 授权许可】

   
2014 Garcia et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Richardson PG, Delforge M, Beksac M, Wen P, Jongen JL, Sezer O, Terpos E, Munshi N, Palumbo A, Rajkumar SV, Harousseau JL, Moreau P, Avet-Loiseau H, Lee JH, Cavo M, Merlini G, Voorhees P, Chng WJ, Mazumder A, Usmani S, Einsele H, Comenzo R, Orlowski R, Vesole D, Lahuerta JJ, Niesvizky R, Siegel D, Mateos MV, Dimopoulos M, Lonial S, et al.: Management of treatment-emergent peripheral neuropathy in multiple myeloma. Leukemia 2012, 26(4):595-608.
• [2]Richardson PG, Weller E, Lonial S, Jakubowiak AJ, Jagannath S, Raje NS, Avigan DE, Xie W, Ghobrial IM, Schlossman RL, Mazumder A, Munshi NC, Vesole DH, Joyce R, Kaufman JL, Doss D, Warren DL, Lunde LE, Kaster S, Delaney C, Hideshima T, Mitsiades CS, Knight R, Esseltine DL, Anderson KC: Lenalidomide, bortezomib, and dexamethasone combination therapy in patients with newly diagnosed multiple myeloma. Blood 2010, 116(5):679-686.
• [3]Velasco R, Petit J, Clapes V, Verdu E, Navarro X, Bruna J: Neurological monitoring reduces the incidence of bortezomib-induced peripheral neuropathy in multiple myeloma patients. J Peripher Nerv Syst 2010, 15(1):17-25.
• [4]Raab MS, Podar K, Breitkreutz I, Richardson PG, Anderson KC: Multiple myeloma. Lancet 2009, 374(9686):324-339.
• [5]Kaufmann H, Raderer M, Wohrer S, Puspok A, Bankier A, Zielinski C, Chott A, Drach J: Antitumor activity of rituximab plus thalidomide in patients with relapsed/refractory mantle cell lymphoma. Blood 2004, 104(8):2269-2271.
• [6]Cavo M, Pantani L, Petrucci MT, Patriarca F, Zamagni E, Donnarumma D, Crippa C, Boccadoro M, Perrone G, Falcone A, Nozzoli C, Zambello R, Masini L, Furlan A, Brioli A, Derudas D, Ballanti S, Dessanti ML, De Stefano V, Carella AM, Marcatti M, Nozza A, Ferrara F, Callea V, Califano C, Pezzi A, Baraldi A, Grasso M, Musto P, Palumbo A: Bortezomib-thalidomide-dexamethasone is superior to thalidomide-dexamethasone as consolidation therapy after autologous hematopoietic stem cell transplantation in patients with newly diagnosed multiple myeloma. Blood 2012, 120(1):9-19.
• [7]Umapathi T, Chaudhry V: Toxic neuropathy. Curr Opin Neurol 2005, 18(5):574-580.
• [8]Argyriou AA, Bruna J, Marmiroli P, Cavaletti G: Chemotherapy-induced peripheral neurotoxicity (CIPN): an update. Crit Rev Oncol Hematol 2012, 82(1):51-77.
• [9]Grisold W, Cavaletti G, Windebank AJ: Peripheral neuropathies from chemotherapeutics and targeted agents: diagnosis, treatment, and prevention. Neuro Oncol 2012, 14(Suppl 4):iv45-iv54.
• [10]Argyriou AA, Iconomou G, Kalofonos HP: Bortezomib-induced peripheral neuropathy in multiple myeloma: a comprehensive review of the literature. Blood 2008, 112(5):1593-1599.
• [11]Johnson DC, Corthals SL, Walker BA, Ross FM, Gregory WM, Dickens NJ, Lokhorst HM, Goldschmidt H, Davies FE, Durie BG, Van Ness B, Child JA, Sonneveld P, Morgan GJ: Genetic factors underlying the risk of thalidomide-related neuropathy in patients with multiple myeloma. J Clin Oncol 2011, 29(7):797-804.
• [12]Lao L, Hamilton GR, Fu J, Berman BM: Is acupuncture safe? A systematic review of case reports. Altern Ther Health Med 2003, 9(1):72-83.
• [13]Ernst E, White AR: Prospective studies of the safety of acupuncture: a systematic review. Am J Med 2001, 110(6):481-485.
• [14]Macpherson H, Scullion A, Thomas KJ, Walters S: Patient reports of adverse events associated with acupuncture treatment: a prospective national survey. Qual Saf Health Care 2004, 13(5):349-355.
• [15]Su JW, Lim CH, Chua YL: Bilateral pneumothoraces as a complication of acupuncture. Singapore Med J 2007, 48(1):e32-e33.
• [16]Peuker E, Gronemeyer D: Rare but serious complications of acupuncture: traumatic lesions. Acupunct Med 2001, 19(2):103-108.
• [17]Chang SA, Kim YJ, Sohn DW, Park YB, Choi YS: Aortoduodenal fistula complicated by acupuncture. Int J Cardiol 2005, 104(2):241-242.
• [18]Shiflett SC, Schwartz GE: Effects of acupuncture in reducing attrition and mortality in HIV-infected men with peripheral neuropathy. Explore (NY) 2011, 7(3):148-154.
• [19]Phillips KD, Skelton WD, Hand GA: Effect of acupuncture administered in a group setting on pain and subjective peripheral neuropathy in persons with human immunodeficiency virus disease. J Altern Complement Med 2004, 10(3):449-455.
• [20]Zhang C, Ma YX, Yan Y: Clinical effects of acupuncture for diabetic peripheral neuropathy. J Tradit Chin Med 2010, 30(1):13-14.
• [21]Tong Y, Guo H, Han B: Fifteen-day acupuncture treatment relieves diabetic peripheral neuropathy. J Acupunct Meridian Stud 2010, 3(2):95-103.
• [22]Wang YP, Ji L, Li JT, Pu JQ, Liu FJ: Effects of acupuncture on diabetic peripheral neuropathies. Zhongguo Zhen Jiu 2005, 25(8):542-544.
• [23]Abuaisha BB, Costanzi JB, Boulton AJ: Acupuncture for the treatment of chronic painful peripheral diabetic neuropathy: a long-term study. Diabetes Res Clin Pract 1998, 39(2):115-121.
• [24]Jiang H, Shi K, Li X, Zhou W, Cao Y: Clinical study on the wrist-ankle acupuncture treatment for 30 cases of diabetic peripheral neuritis. J Tradit Chin Med 2006, 26(1):8-12.
• [25]Wong R, Sagar S: Acupuncture treatment for chemotherapy-induced peripheral neuropathy–a case series. Acupunct Med 2006, 24(2):87-91.
• [26]Donald GK, Tobin I, Stringer J: Evaluation of acupuncture in the management of chemotherapy-induced peripheral neuropathy. Acupunct Med 2011, 29(3):230-233.
• [27]Schroeder S, Meyer-Hamme G, Epplee S: Acupuncture for chemotherapy-induced peripheral neuropathy (CIPN): a pilot study using neurography. Acupunct Med 2012, 30(1):4-7.
• [28]Xu WR, Hua BJ, Hou W, Bao YJ: Clinical randomized controlled study on acupuncture for treatment of peripheral neuropathy induced by chemotherapeutic drugs. Zhongguo Zhen Jiu 2010, 30(6):457-460.
• [29]Zhao ZQ: Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008, 85(4):355-375.
• [30]Han JS: Acupuncture and endorphins. Neurosci Lett 2004, 361(1–3):258-261.
• [31]Mittleman E, Gaynor JS: A brief overview of the analgesic and immunologic effects of acupuncture in domestic animals. J Am Vet Med Assoc 2000, 217(8):1201-1205.
• [32]Schroder S, Liepert J, Remppis A, Greten JH: Acupuncture treatment improves nerve conduction in peripheral neuropathy. Eur J Neurol 2007, 14(3):276-281.
• [33]Atkinson TM, Mendoza TR, Sit L, Passik S, Scher HI, Cleeland C, Basch E: The Brief Pain Inventory and its “pain at its worst in the last 24 hours” item: clinical trial endpoint considerations. Pain Med 2010, 11(3):337-346.
• [34]Kaptchuk TJ: Placebo studies and ritual theory: a comparative analysis of Navajo, acupuncture and biomedical healing. Philos Trans R Soc Lond B Biol Sci 2011, 366(1572):1849-1858.
• [35]Kaptchuk TJ, Kelley JM, Conboy LA, Davis RB, Kerr CE, Jacobson EE, Kirsch I, Schyner RN, Nam BH, Nguyen LT, Park M, Rivers AL, McManus C, Kokkotou E, Drossman DA, Goldman P, Lembo AJ: Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome. BMJ 2008, 336(7651):999-1003.
• [36]Kaptchuk TJ, Stason WB, Davis RB, Legedza AR, Schnyer RN, Kerr CE, Stone DA, Nam BH, Kirsch I, Goldman RH: Sham device v inert pill: randomised controlled trial of two placebo treatments. BMJ 2006, 332(7538):391-397.
• [37]Trotti A, Colevas AD, Setser A, Rusch V, Jaques D, Budach V, Langer C, Murphy B, Cumberlin R, Coleman CN, Rubin P: CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol 2003, 13(3):176-181.
• [38]Dedman P, Al-Khafaji M, Baker K: A Manual of Acupuncture. East Sussex, UK: Journal of Chinese Medicine Publications; 1998.
• [39]Deng LY: Chinese Acupuncture and Moxibustion. Beijing: Foreign Languages Press; 1997.
• [40]Buschbacher RM, Prahlow ND: Manual of Nerve Conduction Studies. 2nd edition. New York: Demos Medical Publishing; 2005.