Acupuncture for Pain and Dysfunction After Neck Dissection: Results of a Randomized Controlled Trial

被引:122
作者
Pfister, David G.
Cassileth, Barrie R.
Deng, Gary E.
Yeung, K. Simon
Lee, Jennifer S.
Garrity, Donald
Cronin, Angel
Lee, Nancy
Kraus, Dennis
Shaha, Ashok R.
Shah, Jatin
Vickers, Andrew J.
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Med, Sect Head & Neck Oncol, New York, NY 10021 USA
[2] Mem Sloan Kettering Canc Ctr, Dept Med, Sect Integrat Med, New York, NY 10021 USA
[3] Mem Sloan Kettering Canc Ctr, Dept Epidemiol Biostat, New York, NY 10021 USA
[4] Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, New York, NY 10021 USA
[5] Mem Sloan Kettering Canc Ctr, Dept Surg, Head & Neck Surg Serv, New York, NY 10021 USA
基金
美国国家卫生研究院;
关键词
QUALITY-OF-LIFE; SPINAL ACCESSORY NERVE; INTENSITY-MODULATED RADIOTHERAPY; STAGE NASOPHARYNGEAL CARCINOMA; CLINICAL-TRIAL; POSTIRRADIATION XEROSTOMIA; SHOULDER; CANCER; HEAD; SCALES;
D O I
10.1200/JCO.2009.26.9860
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose To determine whether acupuncture reduces pain and dysfunction in patients with cancer with a history of neck dissection. The secondary objective is to determine whether acupuncture relieves dry mouth in this population. Patients and Methods Patients at a tertiary cancer center with chronic pain or dysfunction attributed to neck dissection were randomly assigned to weekly acupuncture versus usual care (eg, physical therapy, analgesia, and/or anti-inflammatory drugs, per patient preference or physician recommendation) for 4 weeks. The Constant-Murley score, a composite measure of pain, function, and activities of daily living, was the primary outcome measure. Xerostomia, a secondary end point, was assessed using the Xerostomia Inventory. Results Fifty-eight evaluable patients were accrued and randomly assigned from 2004 to 2007 (28 and 30 patients on acupuncture and control arms, respectively). Constant-Murley scores improved more in the acupuncture group (adjusted difference between groups = 11.2; 95% CI, 3.0 to 19.3; P = .008). Acupuncture produced greater improvement in reported xerostomia (adjusted difference in Xerostomia Inventory = -5.8; 95% CI, -0.9 to -10.7; P = .02). Conclusion Significant reductions in pain, dysfunction, and xerostomia were observed in patients receiving acupuncture versus usual care. Although further study is needed, these data support the potential role of acupuncture in addressing post-neck dissection pain and dysfunction, as well as xerostomia.
引用
收藏
页码:2565 / 2570
页数:6
相关论文
共 49 条
[1]   Acupuncture treatment of patients with radiation-induced xerostomia [J].
Andersen, SW ;
Machin, D .
ORAL ONCOLOGY, 1997, 33 (02) :146-147
[2]  
[Anonymous], HEAD NECK
[3]  
Bolton JE, 1998, J MANIP PHYSIOL THER, V21, P1
[4]   A comparison of pain rating scales by sampling from clinical trial data [J].
Breivik, EK ;
Björnsson, GA ;
Skovlund, E .
CLINICAL JOURNAL OF PAIN, 2000, 16 (01) :22-28
[5]   Phase III randomized trial of amifostine as a radioprotector in head and neck cancer [J].
Brizel, DM ;
Wasserman, TH ;
Henke, M ;
Strnad, V ;
Rudat, V ;
Monnier, A ;
Eschwege, F ;
Zhang, J ;
Russell, L ;
Oster, W ;
Sauer, R .
JOURNAL OF CLINICAL ONCOLOGY, 2000, 18 (19) :3339-3345
[6]   Shoulder disability after different selective neck dissections (Levels II-IV versus levels II-V): A comparative study [J].
Cappiello, J ;
Piazza, C ;
Giudice, M ;
De Maria, G ;
Nicolai, P .
LARYNGOSCOPE, 2005, 115 (02) :259-263
[7]   Comparison between superficial and deep acupuncture in the treatment of the shoulder's myofascial pain: A randomized and controlled study [J].
Ceccherelli, F ;
Bordin, M ;
Gagliardi, G ;
Caravello, M .
ACUPUNCTURE & ELECTRO-THERAPEUTICS RESEARCH, 2001, 26 (04) :229-238
[8]   Cevimeline for the treatment of postirradiation xerostomia in patients with head and neck cancer [J].
Chambers, Mark S. ;
Posner, Marshall ;
Jones, Christopher Uwe ;
Biel, Merrill A. ;
Hodge, Kenneth M. ;
Vitti, Robert ;
Armstrong, Ingrid ;
Yen, Cindy ;
Weber, Randal S. .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2007, 68 (04) :1102-1109
[9]   Objective comparison of shoulder dysfunction after three neck dissection techniques [J].
Cheng, PT ;
Lin, YH ;
Hao, SP ;
Yeh, ARM .
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 2000, 109 (08) :761-766
[10]  
CONSTANT CR, 1987, CLIN ORTHOP RELAT R, P160