— First randomized trial of the noninvasive technique in such patients
by Mike Bassett, Staff Writer, MedPage Today April 22, 2021

Auricular acupressure can reduce chemotherapy-induced peripheral neuropathy (CIPN) symptoms following breast cancer treatment, South Korean researchers reported.

Their randomized trial showed that the technique significantly improved patient-reported CIPN symptoms compared with the use of a sham treatment. Results from the study, led by Mijung Kim, PhD, of the College of Nursing of Chungnam National University in Daejeon, were presented at the Oncology Nursing Society virtual annual meeting.

CIPN can occur following the administration of a variety of antineoplastic agents, such as taxanes, and can seriously affect quality of life, with symptoms sometimes lasting many months.

The problem is very common: in a 2014 review, the prevalence of CIPN one month after finishing chemotherapy was 68%, dropped to 60% at three months, and still occurred in 30% of patients at six months.

Kim noted that while there are a variety of treatments and interventions that have been used to reduce CIPN symptoms, efficacy has been mixed and more treatment options are needed.

She explained that the auricular acupressure used in the study, based on the auricular acupuncture used in traditional Chinese medicine, is a noninvasive technique that involves applying physical pressure to specific points in the ear that are thought to correspond to specific organs and regions of the body. Studies have supported the technique’s clinical use in managing conditions such as menstrual migraine, chronic lower back pain, acute postoperative pain, and insomnia.

In addition, a recent study of the use of the technique in managing CIPN symptoms in 13 cancer patients reported a 38-48% reduction in symptom intensity that was sustained for at least a month.

The new randomized trial involved 44 patients randomly assigned to receive either auricular acupressure or sham treatment. The intervention occurred over a 3-week period, with weekly cycles that included one office visit, five days of treatment application by the patients, and two days of rest.

CIPN symptoms were evaluated before, during, and after the intervention. Evaluations were based on the CIPN-20 questionnaire, in which patients self-assessed sensory, motor, and autonomic symptoms, as well as the total neuropathy score (a physician-based evaluation tool consisting of physician examination and neurologic tests with a total of ten items), and the 11-point numeric rating score (NRS), with higher scores indicating more severe CIPN symptoms.

Patients in the investigational auricular acupressure group had significantly greater improvement in NRS scores compared with the sham group in both upper and lower extremities over time, Kim reported. In addition, the CIPN-20 scores were significantly reduced in the investigational group compared with the sham group — “showing a significant group by time interaction,” she said.

“The experimental group showed a wide difference in physician-assessed test scores between pre- and post-assessment compared to the control group,” she added. “However, this difference remained at an insignificant level.”

“Auricular acupressure has beneficial effects on symptom management in patients with peripheral symptoms after chemotherapy to treat cancer,” Kim concluded. “As a complementary nursing intervention auricular acupressure can contribute to oncology nursing performance in the area of symptom management in clinical settings.”