title: Reduction in nausea and vomiting in children undergoing cancer chemotherapy by either appropriate or sham auricular acupuncture points with standard care.
abstract: BACKGROUND
  Over 40% of children with cancer have reported that chemotherapy-induced nausea and vomiting (CINV) are the two most distressing side-effects of treatment even when antiemetic drugs have been used.
  
  
  OBJECTIVE
  The purpose of this article is to report the findings from a feasibility and pilot study using auricular point acupressure point for CINV in a small group of children in Taiwan.
  
  
  METHODS
  This was a crossover randomized design study. CINV symptoms were assessed on 10 patients just prior to and for 7 days following each of three rounds of chemotherapy drugs (CTX). They received standard care (SC) and were not entered into a test treatment group until they completed the baseline assessment, which was conducted during their first round of chemotherapy after entering the study. Just prior to receiving the second round of CTX, patients were randomized into one of two treatment conditions: auricular acupressure intervention, in addition to standard care (AAP) or auricular acupressure using sham auricular points (SAP) in addition to standard care. For the third round of CTX, they were switched to the other treatment group.
  
  
  RESULTS
  The enrollment rate for this study was 77% of the children invited to participate and of those, 88% provided completed data sets for all three treatment conditions. Patients in the AAP group reported significantly lower occurrence and severity of nausea and vomiting than patients in the SC group (p<0.05). There were no significant differences of nausea and vomiting for patients between the AAP and SAP groups. All of the patients took antiemetic medication on the day they received CTX, and 80% of patients reported that the antiemetics did not help to treat CINV.
  
  
  CONCLUSIONS
  These preliminary findings did show evidence that AAP is acceptable to the children and their parents to prevent/treat CINV. However, there were no statistically significant differences between the AAP and SAP groups in the prevention/treatment of CINV. There were clinical trend differences between the groups, which may due to the small sample size. In a larger study, it would be important to determine whether the effects of the AAP and SAP treatment are independent of any psychologic effects, such as the researcher's increased presence in both treatment groups.
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Chao Hsing
authors.initials: CH
authors.lastname: Yeh
authors.forename: Lung-Chang
authors.initials: LC
authors.lastname: Chien
authors.forename: Yi Chien
authors.initials: YC
authors.lastname: Chiang
authors.forename: Su Wen
authors.initials: SW
authors.lastname: Lin
authors.forename: Chen Kuan
authors.initials: CK
authors.lastname: Huang
authors.forename: Dianxu
authors.initials: D
authors.lastname: Ren
mesh_terms: D020831:Acupuncture, Ear; D000293:Adolescent; D000932:Antiemetics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009325:Nausea / Q000209:etiology / Q000517:prevention & control*; D009369:Neoplasms / Q000188:drug therapy*; D010865:Pilot Projects; D012720:Severity of Illness Index; D059039:Standard of Care; D014839:Vomiting / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents