Acupuncture for Bortezomib-Induced Peripheral Neuropathy: Not Justfor Pain

摘要

>Background: Bortezomib-induced peripheral neuropathy (BIPN) is a common and debilitating side effect. Our pilot study demonstrated that acupuncture is safe and can decrease total neuropathic symptoms. However, there is lack of knowledge in which individual BIPN symptoms benefited from acupuncture. >Purpose: To characterize individual symptoms reduced by acupuncture in patients with BIPN. >Methods: Patients with multiple myeloma treated with bortezomib who developed BIPN grade 2 or above, based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), were enrolled and received 10 acupuncture treatments over 10 weeks. Self-reported BIPN-associated symptoms assessments were collected weekly at baseline, during, and after acupuncture treatment using the Neuropathy Pain Scale (NPS) and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity (FACT/GOG-Ntx) questionnaires. Changes in individual symptoms were analyzed based on FACT/GOG-Ntx and NPS scores. >Results: There were statistically significant reductions in individual symptoms in both NPS and FACT/GOG-Ntx. The FACT/GOG-Ntx reductions were most pronounced in hand/feet numbness/tingling, discomfort, and troublewalking. The sensory symptoms, such as tingling and numbness, especially in thefeet, reduced the most (P < .0001), and motor dysfunctionalso reduced significantly (P = .0001). Both hearing anddysfunction scores were also statistically significantly increased, indicatingimproved symptoms. The NPS scores showed significant symptom relief in all 10items from the NPS assessment, particularly in cold sensitivity and anunpleasant feeling. >Conclusions: Acupuncture can improve multiplesymptoms associated with BIPN, particularly numbness and tingling in hands andfeet, cold sensitivity, and an unpleasant feeling. Further randomized controltrials are warranted to confirm our findings.