Human�/�Clinical Studies
continued...
Vasomotor symptoms
Some studies have reported that acupuncture may be effective in reducing vasomotor symptoms among postmenopausal women with breast cancer and prostate cancer patients on androgen-deprivation therapy.[41,42,43,44,45,46,47] One study randomly assigned 55 patients to acupuncture versus venlafaxine for management of vasomotor symptoms in women with hormone receptor-positive breast cancer. Acupuncture was just as effective as venlafaxine and caused fewer adverse effects.[43]
A phase I pilot study evaluated the effect of acupuncture on tamoxifen-induced menopause symptoms.[42] Fifteen patients with breast cancer who were taking tamoxifen were treated with acupuncture weekly for 3 months. The Greene Menopause Index was used for outcome assessments at baseline before treatment and at 1, 3, and 6 months. The results showed that anxiety, depression, and somatic and vasomotor symptoms, but not libido, were significantly improved in comparison with the baseline (P < .001).
An uncontrolled prospective case series of 50 women on tamoxifen for early breast cancer evaluated women receiving eight treatments of traditional acupuncture weekly. Mean frequency of vasomotor symptoms dropped by 49.8% (P < .0001) at the end of treatment. Seven domains of the Women's Health Questionnaire showed statistically significant improvement.[48]
A retrospective evaluation of 194 patients with predominantly breast or prostate cancer and experiencing vasomotor symptoms found long-term relief of vasomotor symptoms associated with acupuncture and self-acupuncture. The authors suggested that overall treatment dose may be more important than point location, but favored SP6.[49] A small RCT of EA compared with hormone therapy in women with breast cancer suggested a prolonged effect of EA on hot flushes after 24 months. Seven of 19 women initially randomly assigned to EA had 2.1 flushes in 24 hours compared with a baseline of 9.6 flushes in 24 hours.[50] In a prospective randomized study of 84 breast cancer patients on tamoxifen treated with acupuncture versus placebo, acupuncture showed a reduction of hot flashes in both the treatment and the control arms, but there was no difference between true acupuncture and sham acupuncture.[51] The findings from these studies are summarized in Table 4 below.
Table 4. Clinical Studies of Acupuncture: Vasomotor Symptomsa
| Reference Citation(s) | Type of Study | Condition Treated | No. of Patients: Enrolled; Treated; Controlb | Strongest Benefit Reportedc | Concurrent Therapy (Yes/No/ Unknown)d | Level of Evidence Scoree |
| [41] | RCT | Hot flashes in breast cancer patients treated with tamoxifen and aromatase inhibitors | 72; 42; 30 | Reduction of hot flashes but no statistical difference between acupuncture and sham treatment | Yes (SSRIs) | 1iiC |
| [50] | RCT | Hot flushes | 45; 27 EA; 18 hormone therapy | Vasomotor symptoms improved | Unknown | 1iiC |
| [43] | RCT | Hot flashes | 50; 25; 25 | Vasomotor symptoms improved | Yes (tamoxifen or arimidex) | 1iiC |
| [51] | RCT | Hot flashes in breast cancer patients treated with tamoxifen | 84; 74; none | Decrease in severity and frequency in hot flushes and sweating | Yes (tamoxifen) | 1iiC |
| [42] | Phase I pilot study | Menopausal symptoms in breast cancer patients treated with tamoxifen | 15; 15 acupuncture; none | Anxiety, depression, and somatic and vasomotor symptoms improvedf | No | 3iiiC |
| [44] | Pilot study/case series | Hot flashes in patients with prostate cancer | 25; 22; none | 55% treatment for hot flashes | No | 3iiiC |
| [9] | Nonconsecutive case series | Night sweats, hot flashes in patients with cancer | 6; 6 acupuncture; none | Symptoms improved | Yes (not specified) | 3iiiC |
| [49] | Nonconsecutive case series | Vasomotor symptoms for breast and prostate cancer | 194; 194; none | 79% showed 50% or greater reduction in hot flashes | No | 3iiiC |
| [47] | Nonconsecutive case series | Vasomotor symptoms for prostate cancer | 17; 14; none | Decreased hot flashes | Yes (androgen ablation therapy) | 3iiiC |
| [48] | Prospective case series | Hot flashes and night sweats | 54; 50; none | Decreased hot flashes and night sweats and improved physical and emotional well-being | Tamoxifen | 3iiiC |
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