Ultrasound Acupuncture for Oxaliplatin‐induced Peripheral Neuropathy in Patients With Colorectal Cancer: A Pilot Study

Abstract

Background Oxaliplatin is frequently used in the treatment of metastatic colorectal cancer. However, peripheral neuropathy is a severe adverse effect of oxaliplatin that may persist and impact quality of life. Objective To assess the potential effects of ultrasound acupuncture for the alleviation of symptoms related to oxaliplatin‐induced peripheral neuropathy (OIPN) among patients with metastatic colorectal cancer. Design Prospective cohort pilot study. Setting Education and research hospital. Participants Patients with a diagnosis of stage II‐IV colorectal cancer undergoing oxaliplatin‐based treatment regimens who experienced OIPN symptoms (n = 17). Interventions Pulsed therapeutic ultrasound (1 MHz) at bilateral acupuncture points of PC6, PC7, BL60, and KI1 was administered for 5 minutes per point daily for 12 days. Main Outcome Measurements Pain Quality Assessment Scale (PQAS), Chemotherapy‐induced Neurotoxicity Questionnaire (CINQ), quantitative touch‐detection threshold, cold‐trigger pain withdrawal latency, and quality of life (EORTC QLQ‐C30) were measured at baseline (day 0), pre‐intervention (day 12, post wash‐out period), post‐intervention (day 24), and final follow‐up (day 54). A P value of less than .05 was considered statistically significant. Results Scores of PQAS and CINQ significantly improved after ultrasound acupuncture at post‐intervention and follow‐up compared to both baseline and pre‐intervention. Similar trends were also observed for the quantitative sensory testing, where touch‐detection threshold significantly decreased and cold‐trigger pain withdrawal latency significantly increased after ultrasound acupuncture. Patients also showed an improvement on quality of life outcomes as measured by QLQ‐C30 post‐intervention and at follow‐up. Conclusions Ultrasound acupuncture could be an effective intervention for OIPN symptoms for patients with colorectal cancer. However, larger and randomized clinical trials with placebo controls are needed to confirm such effects.

Oxaliplatin-induced peripheral neurotoxicity in colorectal cancer patients: mechanisms, pharmacokinetics and strategies

“…An increasing number of Traditional Chinese Medicines exerted protective effects against OIPN, such as curcumin ( Howells et al, 2019 ), forsythia viridissima ( Yi et al, 2019a ; Yi et al, 2019b ), rutin, quercetin ( Azevedo et al, 2013 ), Huangqi Guizhi Wuwu decoction ( Cheng et al, 2017 ), and resveratrol ( Donald et al, 2017 ), etc. Furthermore, laser acupuncture and ultrasound acupuncture significantly alleviated both oxaliplatin-induced cold and mechanical allodynia and also reduced the incidence and severity of neurotoxicity symptoms, which could be effective interventions for OIPN symptoms in patients with CRC ( Hsieh et al, 2016 ; Chien et al, 2021 ).…”

Chemotherapy-induced peripheral neuropathy in children and adolescent cancer patients

“…Several recent studies, systematic reviews and meta-analyses have investigated acupuncture and related procedures, such as electro or laser acupuncture, for the management of CIPN (Brami et al, 2016;Greenlee et al, 2016;Hsieh et al, 2016;Wong et al, 2016;Derksen et al, 2017;Oh and Kim, 2018;Hwang et al, 2020;Chien et al, 2021). Despite some evidence that acupuncture may decrease sensory neuron hypersensitization through GABA-ergic, serotoninergic and adrenergic effects (Hao et al, 2020), evidence supporting the benefits of acupuncture for the management of CIPN remains limited.…”

Acupuncture for Paclitaxel-Induced Peripheral Neuropathy: A Review of Clinical and Basic Studies

“… 11–15 A series of clinical studies have reported the beneficial effect of acupuncture strategy on improving the symptoms of CIPN that is induced by oxaliplatin, thalidomide, bortezomib and taxane. 16–20 Besides, animal studies have been conducted to investigate the mechanism underpinning the therapeutic efficacies of acupuncture in CIPN as well. 21–25 As a first-line chemotherapeutic agent, taxane (particularly paclitaxel) leads to common and typical CIPN, which is introduced and investigated in both clinical and basic studies.…”