Acupuncture to Prevent Chemotherapy Dose Reduction

描述（由申请人提供）：化疗最有害的副作用之一是化疗引起的周围神经病变（CIPN），这是许多化疗药物常见的致残性和剂量限制性副作用，目前尚无有效治疗方法。剂量强度的微小降低可导致无复发生存期和总生存期的显著降低。我们的初步数据显示，针刺可显著减轻CIPN神经毒性症状，改善神经传导研究，防止因CIPN引起的化疗剂量减少。我们的中心假设是，针刺可以通过增加NGF来预防接受神经毒素化疗的乳腺癌和结直肠癌患者CIPN恶化，提高化疗耐受性。我们的目标是确定针刺在新辅助和辅助环境下减轻乳腺癌和结直肠癌患者CIPN症状和预防由CIPN引起的化疗剂量减少的有效性。我们将进行一项60名患者的随机安慰剂对照试验，以确定针灸对化疗剂量减少的影响，2)确定针灸对预防CIPN恶化的影响，以及3)确定针灸治疗CIPN的机制之一。我们提出的研究将针灸纳入肿瘤学实践，以提高患者对标准化疗的耐受性。我们的研究有可能确定一种有效的非药物治疗CIPN的方法，提高癌症患者对标准化疗方案的耐受性，从而提高其无复发生存期和总生存期。

DESCRIPTION (provided by applicant): One of the most harmful side effects of chemotherapy is chemotherapy-induced peripheral neuropathy (CIPN), a common, disabling and dose-limiting side effect of many chemotherapy agents for which there is no effective treatment. A small reduction in dose intensity can cause a significant decrease in relapse-free survival and overall survival. Our preliminary data showed that acupuncture significantly reduced CIPN neurotoxicity symptoms, improved nerve conduction study, and prevented chemotherapy dose reduction due to CIPN. Our central hypothesis is that acupuncture can prevent worsening of CIPN and improve tolerance of chemotherapy in breast and colorectal cancer patients receiving neurotoxin chemotherapy through increasing NGF. Our goal is to determine the effectiveness of acupuncture in reducing CIPN symptoms and preventing chemotherapy dose reduction caused by CIPN in breast and colorectal cancer patients in the neoadjuvant and adjuvant settings. We will conduct a pilot, 60- patient, randomized, placebo-controlled trial to 1) determine the effect f acupuncture on chemotherapy dose reduction, 2) determine the effect of acupuncture on prevent worsening of CIPN, and 3) identify one of the mechanisms of acupuncture in treating CIPN. Our proposed study will integrate acupuncture into oncology practice to improve to improve patients' tolerance of standard chemotherapy. Our study has the potential to identify an effective non-pharmacological treatment for CIPN and to improve cancer patients' tolerance of standard chemotherapy schedule and subsequently improve their relapse-free survival and overall survival.