title: Acupuncture As an Integrative Approach for the Treatment of Hot Flashes in Women With Breast Cancer: A Prospective Multicenter Randomized Controlled Trial (AcCliMaT).
abstract: To determine the effectiveness of acupuncture for the management of hot flashes in women with breast cancer.
  
  
  
  We conducted a pragmatic, randomized controlled trial comparing acupuncture plus enhanced self-care versus enhanced self-care alone. A total of 190 women with breast cancer were randomly assigned. Random assignment was performed with stratification for hormonal therapy; the allocation ratio was 1:1. Both groups received a booklet with information about climacteric syndrome and its management to be followed for at least 12 weeks. In addition, the acupuncture group received 10 traditional acupuncture treatment sessions involving needling of predefined acupoints. The primary outcome was hot flash score at the end of treatment (week 12), calculated as the frequency multiplied by the average severity of hot flashes. The secondary outcomes were climacteric symptoms and quality of life, measured by the Greene Climacteric and Menopause Quality of Life scales. Health outcomes were measured for up to 6 months after treatment. Expectation and satisfaction of treatment effect and safety were also evaluated. We used intention-to-treat analyses.
  
  
  
  Of the participants, 105 were randomly assigned to enhanced self-care and 85 to acupuncture plus enhanced self-care. Acupuncture plus enhanced self-care was associated with a significantly lower hot flash score than enhanced self-care at the end of treatment (P < .001) and at 3- and 6-month post-treatment follow-up visits (P = .0028 and .001, respectively). Acupuncture was also associated with fewer climacteric symptoms and higher quality of life in the vasomotor, physical, and psychosocial dimensions (P < .05).
  
  
  
  Acupuncture in association with enhanced self-care is an effective integrative intervention for managing hot flashes and improving quality of life in women with breast cancer.
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Lesi
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy. g.razzini-ext@ausl.mo.it.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Razzini
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Muriel Assunta
authors.initials: MA
authors.lastname: Musti
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Stivanello
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Petrucci
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Benedetti
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Ermanno
authors.initials: E
authors.lastname: Rondini
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Maria Bernadette
authors.initials: MB
authors.lastname: Ligabue
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Scaltriti
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Botti
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Artioli
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Mancuso
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cardini
authors.affiliation: Grazia Lesi, Muriel Assunta Musti, Elisa Stivanello, Chiara Petrucci, Pamela Mancuso, and Paolo Pandolfi, Bologna Local Health Authority; Francesco Cardini, Health and Social Agency of Emilia-Romagna Region, Bologna; Giorgia Razzini, Benedetta Benedetti, and Fabrizio Artioli, Civil Hospital, Carpi; Ermanno Rondini, Istituti di Ricovero e Cura a Carattere Scientifico-Arcispedale S. Maria Nuova di Reggio Emilia, Reggio Emilia; Maria Bernadette Ligabue, Civil Hospital, Coreggio; Laura Scaltriti, Civil Hospital, Guastalla; and Alberto Botti, Hospital of Piacenza, Piacenza, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Pandolfi
mesh_terms: D015670:Acupuncture Therapy; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D005260:Female; D019584:Hot Flashes / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012648:Self Care