title: Randomized controlled trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma.
abstract: BACKGROUND
  Xerostomia (dry mouth) after head/neck radiation is a common problem among cancer patients, and available treatments are of little benefit. The objective of this trial was to determine whether acupuncture can prevent xerostomia among head/neck patients undergoing radiotherapy.
  
  
  METHODS
  A randomized, controlled trial among patients with nasopharyngeal carcinoma was conducted comparing acupuncture to standard care. Participants were treated at Fudan University Shanghai Cancer Center, Shanghai, China. Forty patients were randomized to acupuncture treatment and 46 to standard care. Patients were treated 3×/wk on the same days they received radiotherapy. Subjective measures included the Xerostomia Questionnaire and MD Anderson Symptom Inventory-Head and Neck (MDASI-HN). Objective measures were unstimulated and stimulated whole salivary flow rates. Patients were followed for 6 months after the end of radiotherapy.
  
  
  RESULTS
  Xerostomia Questionnaire scores for acupuncture were statistically significantly lower than for controls starting in week 3 through the 6 months (P = .003 at week 3, all other P < .0001), with clinically significant differences as follows: week 11, relative risk (RR) 0.63 (95% confidence interval [CI], 0.45-0.87); 6 months, RR 0.38 (95% CI, 0.19-0.76). Similar findings were seen for MDASI-HN scores. Group differences emerged as early as 3 weeks into treatment for saliva (unstimulated whole salivary flow rate, P = .0004), with greater saliva flow in the acupuncture group at week 7 (unstimulated whole salivary flow rate, P < .0001; stimulated whole salivary flow rate, P = .002) and 11 (unstimulated whole salivary flow rate, P < .02; stimulated whole salivary flow rate, P < .03) and at 6 months (stimulated whole salivary flow rate, P < .003).
  
  
  CONCLUSIONS
  Acupuncture given concurrently with radiotherapy significantly reduced xerostomia and improved quality of life.
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Meng
authors.forename: M Kay
authors.initials: MK
authors.lastname: Garcia
authors.forename: Chaosu
authors.initials: C
authors.lastname: Hu
authors.forename: Joseph
authors.initials: J
authors.lastname: Chiang
authors.forename: Mark
authors.initials: M
authors.lastname: Chambers
authors.forename: David I
authors.initials: DI
authors.lastname: Rosenthal
authors.forename: Huiting
authors.initials: H
authors.lastname: Peng
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhao
authors.forename: Genming
authors.initials: G
authors.lastname: Zhao
authors.forename: Luming
authors.initials: L
authors.lastname: Liu
authors.forename: Amy
authors.initials: A
authors.lastname: Spelman
authors.forename: J Lynn
authors.initials: JL
authors.lastname: Palmer
authors.forename: Qi
authors.initials: Q
authors.lastname: Wei
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cohen
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D002277:Carcinoma; D005260:Female; D006801:Humans; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D011832:Radiation Injuries / Q000517:prevention & control*; D011878:Radiotherapy / Q000009:adverse effects* / Q000379:methods; D014987:Xerostomia / Q000517:prevention & control*; D055815:Young Adult
references.citation: J Oral Rehabil. 1993 Sep;20(5):541-8
references.pmid: 10412476
references.citation: Radiother Oncol. 2000 Nov;57(2):113-8
references.pmid: 11054513
references.citation: Am J Clin Oncol. 2005 Oct;28(5):474-8
references.pmid: 16199987
references.citation: Int J Radiat Oncol Biol Phys. 1997 Feb 1;37(3):571-5
references.pmid: 9112455
references.citation: Support Care Cancer. 1995 May;3(3):168-75
references.pmid: 7655777
references.citation: Int J Radiat Oncol Biol Phys. 2003 May 1;56(1):136-44
references.pmid: 12694832
references.citation: Semin Radiat Oncol. 2003 Jul;13(3):302-8
references.pmid: 12903018
references.citation: Head Neck. 2009 Oct;31(10):1360-8
references.pmid: 19378325
references.citation: Int J Radiat Oncol Biol Phys. 2001 Jul 1;50(3):695-704
references.pmid: 11395238
references.citation: Head Neck. 2007 Jan;29(1):58-63
references.pmid: 16906511
references.citation: J Oral Maxillofac Surg. 1986 Nov;44(11):845-50
references.pmid: 3490558
references.citation: Cancer. 2002 Feb 15;94(4):1151-6
references.pmid: 11920486
references.citation: Laryngoscope. 2010 Nov;120(11):2218-22
references.pmid: 20938964
references.citation: N Engl J Med. 1993 Aug 5;329(6):390-5
references.pmid: 8326972
references.citation: BMC Complement Altern Med. 2008 Jul 07;8:37
references.pmid: 18606019
references.citation: Life Sci. 1998;63(8):659-74
references.pmid: 9718095
references.citation: Head Neck. 2009 Feb;31(2):234-43
references.pmid: 19107948
references.citation: Oral Surg Oral Med Oral Pathol. 1992 Mar;73(3):293-8
references.pmid: 1545961
references.citation: J Altern Complement Med. 2008 Jun;14(5):523-6
references.pmid: 18532895
references.citation: J Clin Oncol. 2000 Oct 1;18(19):3339-45
references.pmid: 11013273
references.citation: Eur J Cancer B Oral Oncol. 1996 May;32B(3):182-90
references.pmid: 8762876
references.citation: Int J Radiat Oncol Biol Phys. 2001 Jun 1;50(2):353-7
references.pmid: 11380221
references.citation: Palliat Med. 2002 May;16(3):235-9
references.pmid: 12047000
references.citation: Arch Otolaryngol Head Neck Surg. 2003 Feb;129(2):251-2
references.pmid: 12578461
references.citation: Radiother Oncol. 2001 Dec;61(3):275-80
references.pmid: 11730997
references.citation: Int J Radiat Oncol Biol Phys. 2000 Nov 1;48(4):1035-9
references.pmid: 11072160
references.citation: Int J Radiat Oncol Biol Phys. 1999 Oct 1;45(3):577-87
references.pmid: 10524409
references.citation: J Dent Res. 1988 Oct;67(10):1334-7
references.pmid: 3262637
references.citation: Int J Radiat Oncol Biol Phys. 1991 May 15;21(1):109-22
references.pmid: 2032882
references.citation: Neuropeptides. 1998 Dec;32(6):543-8
references.pmid: 9920452
references.citation: Neuropeptides. 1999 Jun;33(3):244-50
references.pmid: 10657499
references.citation: Head Neck. 2007 Oct;29(10):923-31
references.pmid: 17358040
references.citation: Am J Clin Oncol. 2005 Aug;28(4):351-8
references.pmid: 16062076
references.citation: Int J Radiat Oncol Biol Phys. 2000 Dec 1;48(5):1339-43
references.pmid: 11121631
references.citation: J Palliat Care. 1999 Winter;15(4):20-3
references.pmid: 10693302
references.citation: J Oral Rehabil. 1997 Mar;24(3):204-8
references.pmid: 9131475
references.citation: Cancer. 1987 Mar 15;59(6):1123-5
references.pmid: 3815287
references.citation: Radiother Oncol. 2000 Jun;55(3):233-9
references.pmid: 11041775
references.citation: Oral Surg Oral Med Oral Pathol. 1986 Mar;61(3):243-8
references.pmid: 3517744
references.citation: Acta Odontol Scand. 1967;25:Suppl 49:1-126
references.pmid: 5299294
references.citation: J Clin Oncol. 2006 Jun 10;24(17):2618-23
references.pmid: 16763274
references.citation: Int J Radiat Oncol Biol Phys. 2002 May 1;53(1):12-22
references.pmid: 12007936
references.citation: Oral Dis. 2000 Jan;6(1):15-24
references.pmid: 10673783
references.citation: Int J Radiat Oncol Biol Phys. 2006 Nov 15;66(4):981-91
references.pmid: 17145528