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Thursday 2 May 2019

Acupuncture improves chemotherapy-induced hand-foot syndrome in cancer patients

Patients with rectal cancer treated with acupuncture showed a significant reduction in severity of chemotherapy-induced hand-foot syndrome compared with control group. The report was published in the World Journal of Acupuncture-Moxibustion.

Hand-foot syndrome (HFS) is also called palmar-plantar erythrodysesthesia. It is an adverse effect of some cancer chemotherapies. Hand-foot syndrome causes abnormal sensation, such as tingling, numbness, burning or itching on the palms and soles, as well as redness, swelling, and pain on the palms of the hands and/or the soles of the feet. Sometimes blisters appear. Hand-foot syndrome sometimes occurs elsewhere on the skin, such as the knees or elbows. But this is less common.

Relieving side effects is an important part of cancer care and treatment. Topical anti-inflammatory medications may help relieve some symptoms. In addition, the doctor may lower the chemotherapy dose or change your chemotherapy schedule, or even may need to temporarily stop your chemotherapy until the symptoms of hand-foot syndrome improve. This could significantly hamper the efficacy of chemotherapy. Acupuncture has been used to treat inflammatory-related conditions.

Recently a clinical study was conducted to assess effect of acupuncture on hand-foot syndrome induced by chemotherapy in patients with rectal cancer. A total of sixty patients with rectal cancer were enlisted and randomly divided into acupuncture group (n=30), and vitamin 6 group (n=30) as the control. The primary acupoints included GV20, LI4, TB5, ST36 and ashi points and supplementary acupoints included KD3, SP6 and GB34 when it is necessary. Acupuncture needles were applied on above acupoints and retained for 30 mins, daily for 2 weeks. Patients within control group took vitamin B6 (oral, 300mg) daily for a total of two weeks.

The primary outcome measures included the Common Toxicity Criteria of the National Cancer Institute of Canada (CTC) and the Karnofsky Performance Scale (KPS). The CTC grades symptoms using a scale of 1–4, with higher scores indicating increased severity. The KPS is on a scale of 0–100, with higher scores indicating an increased ability to perform daily activities and lower scores indicating increased levels of disability. Patients whose CTC scores were reduced to grade 1 following treatment, with a disappearance of symptoms and a KPS score of 90 were categorized as cured. For patients whose CTC scores were reduced to grade 1, with an improvement in symptoms, and a KPS score of 80–89, the treatments were categorized as effective. For patients showing no obvious improvements and had KPS scores of < 80, the treatments were categorized as ineffective. In addition, the QLQ-C30 (Quality of Life Questionnaire Core), a 30-item functional scale covering the areas of PF (physical function), RF (role function), CF (cognitive function), EF (emotional function), and SF (social function) were also monitored before and after the treatment.

The results showed that in the acupuncture group, there were 5 cured (16.7%), 16 effective (53.3%), and 9 ineffective (30%) cases, yielding a total effective rate of 70.0% for rectal cancer patients receiving chemotherapy. In vitamin B6 control group, there were 4 cured (13.3%), 7 effective (23.3%), and 19 ineffective (63.3%) cases, yielding a total effective rate of 36.7% for rectal cancer patients receiving chemotherapy. Positive outcomes with improvements in PF, EF, and CF were greater in the acupuncture group, being of statistical significance (p<0.05) compared with vitamin B6 group.

The data of this study suggests that acupuncture is an effective treatment for hand-foot syndrome, with the ability to alleviate symptoms and improve overall quality of life with rectal cancer patients receiving chemotherapy.

Reference:
F Li et al., Chemotherapy-induced hand-foot syndrome in rectal cancer treated with acupuncture. World Journal of Acupuncture-Moxibustion. 2018, Vol.28 pp. 151-155.     https://www.sciencedirect.com/science/article/pii/S1003525718301144

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