Acupuncture as palliative therapy for physical symptoms and quality of life for advanced cancer patients.
BACKGROUND
Acupuncture is underutilized as an adjunct cancer therapy. The main study objectives were to determine the feasibility of administering acupuncture as palliative therapy to patients with advanced ovarian or breast cancer and to assess the effect on symptoms and quality of life (QOL).


METHODS
This study was a pilot, single-armed prospective clinical trial for patients with advanced cancer to receive 12 acupuncture sessions over 8 weeks with follow-up at weeks 9 and 12. Ambulatory patients with advanced ovarian or breast cancer were enrolled to receive treatments at an outpatient academic oncology center. Symptom severity was measured before and after each acupuncture session.A composite QOL assessment tool, consisting of validated instruments, was completed at 5 time points.


RESULTS
Forty patients enrolled in the study. Twenty-eight patients (70%; 95% confidence interval [CI] = 53%-83%) completed 4 weeks of treatment, and 26 patients (65%; 95% CI = 48%-79%) completed 8 weeks. Eight patients (20%) withdrew before receiving acupuncture, and 6 patients (15%) discontinued treatment early because of disease progression or scheduling demands. Among all 32 assessed patients, there was self-reported improvement immediately post-treatment in anxiety,fatigue, pain, and depression and significant improvement over time for patients with anxiety (P = .001) and depression(P = .02). Among patients experiencing baseline symptoms, there was improvement in anxiety (P = .001), fatigue (P = .0002),pain (P = .0002), and depression (P = .003). QOL measures of pain severity and interference, physical and psychological distress, life satisfaction, and mood states showed improved scores during treatment, with sustained benefit at 12 weeks.


CONCLUSIONS
This pilot study demonstrates that an 8-week outpatient acupuncture course is feasible for advanced cancer patients and produces a measurable benefit that should be evaluated in controlled trials.
Dean-Clower
Elizabeth
E
Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, 44 Binney St., Boston, MA 02115, USA.
Doherty-Gilman
Anne M
AM
Keshaviah
Aparna
A
Baker
Frank
F
Kaw
Chiewkwei
C
Lu
Weidong
W
Manola
Judith
J
Penson
Richard T
RT
Matulonis
Ursula A
UA
Rosenthal
David S
DS
D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D013997:Time Factors