Acupuncture for Chemotherapy-Induced Peripheral Neuropathy: Is It Effective?

Among patients with chemotherapy-induced peripheral neuropathy (CIPN), acupuncture enhanced structural regeneration of the sural nerve, according to study findings published in the journal Phytomedicine.

Chemotherapeutic agents cause cellular and DNA damage and inflammation which evoke peripheral nerve degeneration and small fiber neuropathy. Previous research has indicated that acupuncture may be beneficial among patients with neuropathy.

To evaluate whether acupuncture may improve symptoms of CIPN, the Acupuncture for Chemotherapy-Induced Neuropathy (ACICIN) study was conducted between 2012 and 2015 at the University Medical Center Hamburg-Eppendorf in Germany. This prospective, controlled, randomized, 2-armed, cross-over study recruited 60 patients with CIPN. Patients received weekly acupuncture for 10 weeks before or after a 10-week waiting period. Patients were evaluated for change in sural sensory nerve action potential (SNAP), sural sensory nerve conduction velocity (SNCV), tibial motor nerve conduction velocity (MNCV), tibial nerve distal motoric latency (DML), and patient-reported outcome measures (PROMs).

Patients were aged mean 60.7 (range, 40-79) years, 51 were women, they had received their last chemotherapy 32.2 (range, 2-133) months previously, 25 had received paclitaxel or docetaxel, and 19 had received oxaliplatin or cisplatin.

Compared with the control phase of the study, acupuncture associated with significant changes to sural SNAP (f, 0.55; P <.01) and sural SNCV (f, 0.49; P <.01). The acupuncture therapy did not appear to have an effect on tibial MNAP, MNCV, or DML.

Acupuncture was also associated with improvements in burning pain (f, 0.44; P <.01), numbness (f, 0.42; P <.01), pallhypesthesia dorsum of foot (f, 0.39; P <.01), blind walking (f, 0.38; P <.01), cramps (f, 0.37; P <.01), frequency of symptoms (f, 0.37; P <.01), unsteadiness of gait (f, 0.35; P <.05), neuropathic deficit score (f, 0.31; P <.05), and heel to toe walking (f, 0.29; P <.05).

A potential limitation of this study was including multiple cancer and chemotherapy types.

“The ACUCIN trial showed that acupuncture significantly improves sensory NCS, as well as clinical findings and PROMs in CIPN after 10 treatments, suggesting structural neuroregeneration,” the researchers stated, which indicates that acupuncture may be a viable treatment option for patients with CIPN.

The researchers concluded, “Long-term efficacy of acupuncture for CIPN needs further evaluation. Moreover, subsequent studies should investigate the possible preventive effect of acupuncture if applied during chemotherapy.”

Reference

Friedemann T, Kark E, Cao N, et al. Acupuncture improves chemotherapy-induced neuropathy explored by neurophysiological and clinical outcomes – the randomized, controlled, cross-over ACUCIN trial. Phytomedicine. Published online June 26, 2022. doi:10.1016/j.phymed.2022.154294