Acupuncture reduces radiation-induced dry mouth for cancer patients



Acupuncture reduces radiation-induced dry mouth for cancer patients


A study from researchers at The University of Texas MD Anderson Cancer Centre has revealed that head and neck cancer patients experienced less dry mouth after receiving acupuncture treatment three days a week during the course of radiation treatment.

The trial, published in JAMA Network Open, is the first randomised, placebo-controlled, Phase III trial to evaluate the use of acupuncture during radiation therapy to reduce the incidence and severity of radiation-induced xerostomia, or dry mouth.

Acupuncture has very few side effects and is relatively low in cost when compared to treatments that are often used for dry mouth, such as medication and saliva substitutes. The results support a 2011 study that discovered acupuncture sessions improved symptoms for up to six months after the radiation treatment.

"Dry mouth is a serious concern for head and neck cancer patients undergoing radiation therapy. The condition can affect up to 80 percent of patients by the end of radiation treatment," said the study's principal investigator, Lorenzo Cohen, Ph.D., professor of Palliative, Rehabilitation, and Integrative Medicine and director of the Integrative Medicine Program. "The symptoms severely impact quality of life and oral health, and current treatments have limited benefits."

True acupuncture (TA) had significantly lower xerostomia scores than standard care control (SCC), and marginally lower than sham acupuncture (SA). There were no differences between SA and SCC. One year after finishing radiation therapy, the incidence of clinically significant xerostomia was 35% in the TA group, 48% in the SA group and 55% in the SCC group.

The study involved 339 head and neck cancer patients who were undergoing radiation treatment over a 4 year period. The participants were divided into three groups – the first group received true acupuncture, the second received sham acupuncture, and the third group (the SCC group) received radiation and oral health education but no acupuncture. No participants had received acupuncture prior to participating in the study.

Patients in either the TA or SA groups received acupuncture three days a week on the same day as their radiation treatment, which lasted six to seven weeks. The sham procedure involved a real needle at a point not indicated for xerostomia, real needles at sham points, and placebo needles at sham points.

Results were based on data from self-report questionnaires. The participants completed the Xerostomia Questionnaire (XQ) – this is an eight-item survey assessing the symptoms. XQ scores under 30 corresponded to mild or no symptoms of xerostomia. The data was collected at baseline, at the end of radiotherapy, and three, six, and twelve months after radiation treatment was finished.

The results showed that TA led to significantly fewer and less severe dry mouth symptoms one year after treatment. The score in the TA group averaged 26.6, while the SA group averaged 31.3, and the SCC group averaged 34.8.

The Acupuncture Expectancy Scale (AES) was also used to measure the relationship between expectations related to acupuncture and clinical response. The AES was completed by participants at baseline, after four acupuncture sessions, and at the end of the acupuncture treatment. There were no group differences or differences between sites.

"The evidence is to a point where patients should incorporate acupuncture alongside radiation treatment as a way to prevent the severity of dry mouth symptoms," said Cohen. "I think with this study we can add acupuncture to the list for the prevention and treatment of xerostomia, and the guidelines for the use of acupuncture in the oncology setting should be revised to include this important chronic condition."


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