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Human�/�Clinical Studies

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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

EA = electroacupuncture; No. = number; RCT = randomized controlled trial; SSRIs = selective serotonin reuptake inhibitors.
a See text and the NCI Dictionary of Cancer Terms for additional information and definition of terms.
b Number of patients treated plus number of patient controls may not equal number of patients enrolled; number of patients enrolled equals number of patients initially considered by the researcher who conducted a study; number of patients treated equals number of enrolled patients who were given the treatment being studied AND for whom results were reported.
c Strongest evidence reported that the treatment under study has anticancer activity or otherwise improves the well-being of cancer patients.
d Concurrent therapy for symptoms treated (not cancer).
e For information about levels of evidence analysis and an explanation of the level of evidence scores, see Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.
fP < .001, versus baseline.
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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Last Updated: May 16, 2012
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