Highlights
- •This trial recruited 173 patients with non-small cell lung cancer or mesothelioma.
- •Patients were randomised to acupuncture alone (A), morphine alone (M) or both (AM).
- •Dyspnoea visual analogue scale improved ≥1.5 in 74%, 60% and 66% of arms A, M and AM, respectively.
- •There was no statistically significant difference in dyspnoea control between arms.
- •Acupuncture additionally relieved anxiety and acted as a morphine sparing treatment.
Abstract
Background
Dyspnoea is one of the commonest symptoms of lung cancer. Opioids can reduce dyspnoea.
This study investigates acupuncture for relief of breathlessness in lung cancer.
Methods
We performed a single-centre, randomised phase II study of 173 patients with non-small
cell lung cancer or mesothelioma with dyspnoea score of ≥4 on visual analogue scale
(VAS). Randomisation was to acupuncture alone (A), morphine alone (M) or both (AM).
Acupuncture was administered at upper sternal, thoracic paravertebral, trapezius trigger
points and LI4. Manubrial semi-permanent acupuncture studs were inserted and massaged
when symptomatic. Arm A patients received rescue morphine. Primary end-point was proportion
of patients achieving ≥1.5 improvement in VAS dyspnoea at 4 h. Measurements continued
to day 14 and included VAS relaxation, line analogue rating (Lar) anxiety, hospital
anxiety and depression and European Organisation for Research and Treatment of Cancer
quality-of-life scores.
Results
Dyspnoea VAS improved ≥1.5 in 74%, 60% and 66% of arms A, M and AM, respectively,
and was maintained in 45% at 2 weeks. There was no statistically significant difference
between arms. VAS relaxation improved in arms A (1.06 points) and AM (1.48 points)
compared to arm M (–0.19 points, p<0.001). At 7 d, the Lar anxiety score improved in arm A (1.5 points), arm AM (1.2
points) and arm M (no change, p=0.003). Fewer patients received at least one morphine dose in arm A compared with
arm M or AM (21% versus 87% versus 87%, respectively, p<0.001).
Conclusions
A, M and AM were effective in relieving dyspnoea. Acupuncture relieved anxiety and
was morphine sparing, providing an alternative to morphine.
Keywords
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Article info
Publication history
Published online: May 05, 2016
Accepted:
March 21,
2016
Received:
March 15,
2016
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
