Acupuncture Improves Symptoms of Radiation-Induced Xerostomia in Head and Neck Cancer

Acupuncture can improve symptoms of radiation-induced xerostomia in patients with head and neck cancer, according to a phase 3 trial presented at the ASCO Annual Meeting 2022.

Patients who underwent true acupuncture reported greater improvements in symptoms and quality of life than did patients who underwent sham acupuncture and those who received standard oral hygiene alone.

These results suggest that acupuncture should be considered for treating radiation-induced xerostomia, said study presenter Lorenzo Cohen, PhD, of MD Anderson Cancer Center in Houston.

Dr Cohen explained that current treatments for radiation-induced xerostomia have a low success rate, but small studies have suggested that acupuncture may relieve symptoms. 

The researchers therefore set out to evaluate acupuncture in a randomized, phase 3, controlled trial. The trial enrolled adults with squamous cell carcinoma of the head and neck. The patients had received bilateral radiation therapy and subsequently developed grade 2-3 xerostomia. All patients completed radiation therapy at least 12 months before enrollment, and parotid glands and at least 1 submandibular gland were intact. 

A total of 258 patients underwent randomization. They all received standard oral hygiene and were randomly assigned to undergo true acupuncture (n=86), sham acupuncture (n=86), or no additional intervention (n=86). Patients who underwent acupuncture did so twice weekly for 4 weeks. Patients who achieved a minor response continued with true or sham acupuncture for an additional 4 weeks. 

Baseline characteristics were well balanced across the arms. A majority of patients were men, were White, had stage IV disease, and had an ECOG performance status score of 0. The median time from diagnosis to enrollment was around 4 years in each arm.  

Results

At week 4, xerostomia symptoms improved significantly in the true acupuncture group compared with the sham acupuncture group (P =.06) and the group that received oral hygiene alone (P =.0008). 

A response at 4 weeks was more likely in the true acupuncture group as well. The rate of partial response was 31.3% in the true acupuncture group, 17.1% in the sham acupuncture group, and 14.1% in the oral hygiene group. The rate of minor response was 18.1%, 21.1%, and 15.6%, respectively.

At 12 weeks, both the true acupuncture group (P =.02) and the sham acupuncture group (P =.04) had significant improvements in symptoms compared with the oral hygiene group. There was no significant difference between the true and sham acupuncture groups (P =.78).

Quality of life scores, as measured by the FACT-G questionnaire, were significantly higher in the true acupuncture group than in the sham acupuncture group (P =.02) and the oral hygiene group (P =.001). 

“In summary, we found that true acupuncture was more effective in treating chronic radiation-induced xerostomia and improving quality of life 1 or more years later, and, for some of these patients, they’d been suffering for 17 years with this condition,” Dr Cohen said. 

He noted that sham acupuncture was tied to some modest improvements, but all outcomes favored true acupuncture.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Cohen L, Danhauer S, Rosenthal DI, et al. A phase III, randomized, sham-controlled trial of acupuncture for treatment of radiation-induced xerostomia (RIX) in patients with head and neck cancer: Wake Forest NCI Community Oncology Research Program Research Base (WF NCORP RB) trial WF-97115. Presented at ASCO 2022; June 3-7, 2022. Abstract 12004.

This article originally appeared on Cancer Therapy Advisor