title: Sham-controlled, randomised, feasibility 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. Quality of life (QOL) is impaired, and available treatments are of little benefit. This trial determined the feasibility of conducting a sham-controlled trial of acupuncture and whether acupuncture could prevent xerostomia among head/neck patients undergoing radiotherapy.
  
  
  METHODS
  A sham controlled, feasibility trial was conducted at Fudan University Shanghai Cancer Center, Shanghai, China among patients with nasopharyngeal carcinoma undergoing radiotherapy. To determine feasibility of a sham procedure, 23 patients were randomised to real acupuncture (N=11) or to sham acupuncture (N=12). Patients were treated three times/week during the course of radiotherapy. Subjective measures were the Xerostomia Questionnaire (XQ) and MD Anderson Symptom Inventory for Head and Neck Cancer (MDASI-HN). Objective measures were unstimulated whole salivary flow rates (UWSFR) and stimulated salivary flow rates (SSFR). Patients were followed for 1 month after radiotherapy.
  
  
  RESULTS
  XQ scores for acupuncture were significantly lower than sham controls starting in week 3 and lasted through the 1-month follow-up (all P's <0.001 except for week 3, which was 0.006), with clinically significant differences as follows: week 6 - RR 0.28 [95% confidence interval, 0.10, 0.79]; week 11 - RR 0.17 [95%CI, 0.03, 1.07]. Similar findings were seen for MDASI-HN scores and MDASI-Intrusion scores. Group differences for UWSFR and SSFR were not found.
  
  
  CONCLUSIONS
  In this small pilot study, true acupuncture given concurrently with radiotherapy significantly reduced xerostomia symptoms and improved QOL when compared with sham acupuncture. Large-scale, multi-centre, randomised and placebo-controlled trials are now needed.
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China. mengzhq@sh163.net
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Meng
authors.forename: M
authors.initials: M
authors.lastname: Kay 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: Caijun
authors.initials: C
authors.lastname: Wu
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
authors.initials: J
authors.lastname: Lynn 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; D000368:Aged; D002277:Carcinoma; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D012472:Salivation; D014987:Xerostomia / Q000517:prevention & control*