A pilot study of acupuncture in treating bortezomib-induced peripheral neuropathy in patients with multiple myeloma.
A pilot study of acupuncture in treating bortezomib-induced peripheral neuropathy in patients with multiple myeloma.
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DOI：
10.1177/1534735414534729
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发表时间：
2014-09
影响因子：
2.9
通讯作者：
Badros AZ
中科院分区：
文献类型：
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作者：
Bao T;Goloubeva O;Pelser C;Porter N;Primrose J;Hester L;Sadowska M;Lapidus R;Medeiros M;Lao L;Dorsey SG;Badros AZ
周围神经病变是硼替佐米对多发性骨髓瘤（MM）患者的剂量限制性毒性。探讨针刺减轻硼替佐米诱导的周围神经病变（BIPN）症状的安全性、可行性和有效性。尽管进行了充分的医疗干预并停用硼替佐米，但持续BIPN≥2级的MM患者接受10次针灸治疗，疗程为10周（2次/周，1次/周，4周，然后每两次，4周）。通过临床总神经病变评分（TNSc）、肿瘤治疗功能评估/妇科肿瘤组神经毒性（FACT/GOG-Ntx）问卷和神经病变疼痛量表（NPS）评估反应。重复测量方差分析用于检验每项测量得分的单调下降。在基线和第1、2、4、8和14周获得促炎和神经营养细胞因子的系列血清水平。27名MM患者参加了该试验。没有与针灸治疗相关的不良事件。TNSc数据被认为无效，因此未报告。在第10周和第14周，FACT/GOG-Ntx和NPS显示明显减少，表明疼痛减轻，功能改善（第10周和第14周FACT/GOG-Ntx和NPS的P值均< 0.0001）。然而，神经传导研究在基线评估和研究结束之间没有显著变化。有反应者和无反应者的血清细胞因子没有相关性。针灸安全、可行，能主观改善患者的症状。后续随机对照试验是有必要的。
Peripheral neuropathy is the dose limiting toxicity of bortezomib in patients with multiple myeloma (MM). To examine the safety, feasibility and efficacy of acupuncture in reducing bortezomib-induced peripheral neuropathy (BIPN) symptoms. Patients with MM experiencing persistent BIPN ≥grade 2 despite adequate medical intervention and discontinuation of bortezomib received 10 acupuncture treatments for 10 weeks (2×/week for 2 weeks, 1×/week for 4 weeks, and then biweekly for 4 weeks). Responses were assessed by the Clinical Total Neuropathy Score (TNSc), Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity (FACT/GOG-Ntx) questionnaire, and the Neuropathy Pain Scale (NPS). Repeated-measures analysis of variance was used to test for monotonic decline in scores on each of the measures. Serial serum levels of proinflammatory and neurotrophic cytokines were obtained at baseline and weeks 1, 2, 4, 8, and 14. Twenty-seven patients with MM were enrolled in the trial. There were no adverse events associated with the acupuncture treatments. TNSc data were deemed invalid and therefore were not reported. At weeks 10 and 14, FACT/GOG-Ntx and NPS showed significant reduction suggesting decreased pain, and improved function (P values were <.0001 for both FACT/GOG-Ntx and NPS at weeks 10 and 14). However, nerve conduction studies did not significantly change between baseline assessment and end of study. There was no correlation in serum cytokines for responders versus none responders. Acupuncture is safe, feasible and produces subjective improvements in patients’ symptoms. A follow-up randomized controlled trial is warranted.