Predictors of acupuncture use among children and adolescents with cancer.
BACKGROUND
Evidence for the application of acupuncture in pediatric oncology is limited. We investigated the acceptance of acupuncture and factors associated with its use among children and adolescents with cancer.


METHODS
Ninety acupuncture-naïve children receiving cancer treatment at Columbia University Medical Center (CUMC) provided consent/assent for participation. Participants could choose to receive or refuse integrative services offered at CUMC. Symptoms were collected for a 6-month period with the Memorial Symptom Assessment Scale (MSAS). Acute and delayed adverse events among participants who received acupuncture were recorded.


RESULTS
Fifty-four percent of the participants elected to receive acupuncture. In total, 252 acupuncture sessions were administered with a median of four sessions per patient (range 1-13 sessions). Pain (56%), nausea (51%), lack of energy (50%), and irritability (43%) were the most frequently reported symptoms in the whole cohort. Determinants of acupuncture use included older age and ethnicity. Acupuncture was more likely than other integrative modalities to be used for gastrointestinal and constitutional symptoms including drowsiness (odds ratio [OR], 3.34; 95% confidence interval [CI], 1.98-5.66; P < 0.0001), lack of energy (OR, 3.23; 95% CI, 1.78-5.87; P = 0.0001), and pain (OR, 2.63; 95% CI, 1.46-4.72; P = 0.001). Adverse events were reported by 3% of the participants. There was no increased incidence of adverse events in children with thrombocytopenia (P = 0.189) or neutropenia (P = 0.497).


CONCLUSIONS
Our results highlight the potential use of acupuncture as a safe, adjunctive therapy for symptom management within existing supportive care regimens in pediatric oncology and potential areas to focus research initiatives.
Department of Obstetrics and Gynecology, Cooper University Hospital, Camden, New Jersey.
Sagar K
SK
Chokshi
Division of Pediatric Hematology, Oncology, and Stem Cell Transplant, Columbia University Medical Center, New York, New York.|Institute of Human Nutrition, Columbia University Medical Center, New York, New York.
Elena J
EJ
Ladas
Division of Pediatric Hematology, Oncology, and Stem Cell Transplant, Columbia University Medical Center, New York, New York.
Katherine
K
Taromina
Division of Pediatric Hematology, Oncology, and Stem Cell Transplant, Columbia University Medical Center, New York, New York.
Douglas
D
McDaniel
Division of Pediatric Hematology, Oncology, and Stem Cell Transplant, Columbia University Medical Center, New York, New York.
Diane
D
Rooney
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York.
Zhezhen
Z
Jin
Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York.
Wei-Chun
WC
Hsu
Division of Pediatric Hematology, Oncology, and Stem Cell Transplant, Columbia University Medical Center, New York, New York.
Kara M
KM
Kelly
D015670:Acupuncture Therapy / Q000523:psychology / Q000706:statistics & numerical data*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011446:Prospective Studies; D055815:Young Adult
acupuncture therapy; integrative medicine; pediatric oncology; supportive care