- •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.
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.
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.
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).
A, M and AM were effective in relieving dyspnoea. Acupuncture relieved anxiety and was morphine sparing, providing an alternative to morphine.
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- The experience of breathlessness in lung cancer.Eur J Cancer Care (Engl). 1999; 8: 37-43
- Opioids for the palliation of breathlessness in terminal illness.Cochrane Database Syst Rev. 2001; 4: CD002066
- The prevalence of complementary/alternative medicine in cancer: a systematic review.Cancer. 1998; 83: 777-782
- What is the evidence for the use of acupuncture as an intervention for symptom management in cancer supportive and palliative care: an integrative overview of reviews.Support Care Cancer. 2013; 21: 2913-2923
- Acupuncture for cancer pain and related symptoms.Curr Pain Headache Rep. 2013; 17: 321
- Acupuncture in cancer patients and palliative care.in: Filshie J. White A.R. Cummings M. Medical acupuncture: a western scientific approach. Elsevier, London2016 (in press)
- Acupuncture and immune modulation.Auton Neurosci. 2010; 157: 38-41
- Use of acupuncture in hospices and palliative care services in the UK.Acupunct Med. 2013; 31: 16-22
- Controlled trial of acupuncture for disabling breathlessness.Lancet. 1986; 2: 1416-1419
- A randomized, placebo-controlled trial of acupuncture in patients with chronic obstructive pulmonary disease (COPD): the COPD-acupuncture trial (CAT).Arch Intern Med. 2012; 172: 878-886
- Effectiveness of acupressure in improving dyspnoea in chronic obstructive pulmonary disease.J Adv Nurs. 2004; 45: 252-259
- Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases.Cochrane Database Syst Rev. 2008; 2: CD005623
- Acupuncture for the relief of cancer-related breathlessness.Palliat Med. 1996; 10: 145-150
- Acupuncture analgesia – basic research.in: Stux G.H. Clinical acupuncture: scientific basis. Springer-Verlag, Berlin2001
- Electroacupuncture analgesia is mediated by stereospecific opiate receptors and is reversed by antagonists of type I receptors.Life Sci. 1980; 26: 631-638
- Neural mechanism underlying acupuncture analgesia.Prog Neurobiol. 2008; 85: 355-375
- Measurement of feelings using visual analogue scales.Proc R Soc Med. 1969; 62: 989-993
- The Leeds Sleep Evaluation Questionnaire in psychopharmacological investigations – a review.Psychopharmacology (Berl). 1980; 71: 173-179
- Introducing a placebo needle into acupuncture research.Lancet. 1998; 352: 364-365
- Are minimal, superficial or sham acupuncture procedures acceptable as inert placebo controls?.Acupunct Med. 2006; 24: 13-15
- Expectancy and belief modulate the neuronal substrates of pain treated by acupuncture.Neuroimage. 2005; 25: 1161-1167
- The power of the placebo in symptom management.J Clin Oncol. 2015; 33: 1870-1872
- Acupuncture for dyspnea in advanced cancer: a randomized, placebo-controlled pilot trial [ISRCTN89462491].BMC Palliat Care. 2005; 4
- Which measurement scales should we use to measure breathlessness in palliative care? A systematic review.Palliat Med. 2007; 21: 177-191
- Physiological and endocrine effects of social contact.Ann N Y Acad Sci. 1997; 807: 146-163
- The validity of the hospital anxiety and depression scale. An updated literature review.J Psychosom Res. 2002; 52: 69-77
- Integrated collaborative care for major depression comorbid with a poor prognosis cancer (SMaRT Oncology-3): a multicentre randomised controlled trial in patients with lung cancer.Lancet Oncol. 2014; 15: 1168-1176
- Acupuncture for anxiety and anxiety disorders–a systematic literature review.Acupunct Med. 2007; 25: 1-10
Published online: May 05, 2016
Accepted: March 21, 2016
Received: March 15, 2016
© 2016 Elsevier Ltd. All rights reserved.