The Efficacy of Moxibustion for Breast Cancer Patients with Chemotherapy-Induced Myelosuppression during Adjuvant Chemotherapy: A Randomized Controlled Study

Abstract

Objective. The randomized controlled clinical trial aims to investigate the clinical efficacy of moxibustion for breast cancer patients with chemotherapy-induced myelosuppression (CIM) during adjuvant chemotherapy. Methods. Surgically resected breast cancer patients were randomly divided into the moxibustion group (MOX; n = 48) and control group (CON; n = 44). Routine adjuvant chemotherapy (every 21 days, 4–8 cycles) and supportive recombinant human granulocyte colony-stimulating factor were given to both groups, while MOX received an additional moxibustion treatment (once daily after each cycle of chemotherapy). Primary endpoints included the grade of myelosuppression in terms of white blood cell (WBC) and absolute neutrophil count (ANC) and the incidence of myelosuppression-related serious adverse events (SAEs). Other measures included treatment compliance, adverse events (AEs), and survival. Results. WBC counts were generally higher in MOX and were dramatically higher than those in CON at the 7th course of chemotherapy ( P = 0.008 ), while grade 1 ANC reduction was dramatically lower than that in CON at the 7thcourse of chemotherapy ( P = 0.006 ). These effects were particularly significant in patients receiving anthracycline-taxane combination regimens. Moreover, MOX had fewer febrile neutropenia than CON ( P = 0.051 ). MOX demonstrated a lower incidence of grade 3–4 myelosuppression ( P < 0.05 ). AEs including grade 2–3 severe nausea, various kinds of pains, and vertigo occurred less frequently in MOX ( P < 0.05 ). No difference in survival was observed between the two groups ( P > 0.05 ). Conclusion. Moxibustion is effective for treating CIM in breast cancer patients during adjuvant chemotherapy, especially for patients receiving high-dose, long-term, and combined chemotherapy regimens. Moxibustion can reduce the incidence of myelosuppression-related SAE and improve the compliance and safety of chemotherapy in breast cancer.

Effectiveness of Acupuncture in Relieving Chemotherapy-induced Leukopenia in Patients With Breast Cancer: A Systematic Review With A Meta-Analysis and Trial Sequential Analysis

“…In total, there were 51 studies remaining for full manuscript review, of which 41 studies were excluded due to the following reasons: different target population (n = 17), study protocols (n = 2), non-relevant outcomes (n = 21), non-RCT study design (n = 1). Finally, ten studies 29-38 were included for further qualitative and quantitative analyses. The PRISMA flow diagram of the review process is presented in Figure 1.…”

“…Three studies [31][32][33] reported neither the procedure for allocation concealment nor blinding of participants and personnel in the research, so they presented a high risk of bias. For the item of blinding of the outcome assessment, four 29,33,36,38 were classified as having low risk, and one had high risk. In terms of how the studies addressed incomplete outcome data, 8 studies [29][30][31][32][33][34][35]38 were classified as having low risk with reported rates of follow-up and withdrawal, and the remaining 2 had high risk.…”

“…For the item of blinding of the outcome assessment, four 29,33,36,38 were classified as having low risk, and one had high risk. In terms of how the studies addressed incomplete outcome data, 8 studies [29][30][31][32][33][34][35]38 were classified as having low risk with reported rates of follow-up and withdrawal, and the remaining 2 had high risk. Seven studies 29,30,32,34,[36][37][38] had a low risk of selective reporting.…”

“…In total, there were 51 studies remaining for full manuscript design (n = 1). Finally, ten studies [29][30][31][32][33][34][35][36][37][38] were included for further qualitative and quantitative analyses. The PRISMA flow diagram of the review process is presented in Figure 1.…”

“…Papers were published between 2012 and 2019. Most were carried out in China [30][31][32][33][34][35][36][37][38] ; only one took place in Australia. 29 The interventions used different types of acupuncture, including 2 with manual acupuncture, 2 trials with electroacupuncture, 2 with acupoint catgut embedding, and 4 moxibustion.…”