Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting

Jeanette Ezzo, Andrew Vickers, Mary Ann Richardson, Claire Allen, Suzanne L. Dibble, Brian Issell, Lixing Lao, Michael Pearl, Gilbert Ramirez, Joseph A. Roscoe, Joannie Shen, Jane Shivnan, Konrad Streitberger, Imad Treish, Grant Zhang

Research output: Contribution to journalReview article

Abstract

Purpose: Assess the effectiveness of acupuncture-point stimulation on acute and delayed chemotherapy-induced nausea and vomiting in cancer patients. Materials and Methods: Randomized trials of acupuncture-point stimulation by needles, electrical stimulation, magnets, or acupressure were retrieved. Data were provided by investigators of the original trials and pooled using a fixed-effects model. Results: Eleven trials (N = 1,247) were pooled. Overall, acupuncture-point stimulation reduced the proportion of acute vomiting (relative risks [RR] = 0.82; 95% Cl, 0.69 to 0.99; P = .04), but not the mean number of acute emetic episodes or acute or delayed nausea severity compared with controls. By modality, stimulation with needles reduced the proportion of acute vomiting (RR = 0.74; 95% Cl, 0.58 to 0.94; P = .01), but not acute nausea severity. Electroacupuncture reduced the proportion of acute vomiting (RR = 0.76; 95% Cl, 0.60 to 0.97; P = .02), but manual acupuncture did not; delayed symptoms were not reported. Acupressure reduced mean acute nausea severity (standardized mean difference = -0.19; 95% Cl, -0.38 to -0.01 ; P = .03) and most severe acute nausea, but not acute vomiting or delayed symptoms. Noninvasive electrostimulation showed no benefit for any outcome. All trials used concomitant pharmacologic antiemetics, and all, except electroacupuncture trials, used state-of-the-art antiemetics. Conclusion: This review complements data on postoperative nausea and vomiting, suggesting a biologic effect of acupuncture-point stimulation. Electroacupuncture has demonstrated benefit for chemotherapy-induced acute vomiting, but studies with state-of-the-art antiemetics as well as studies for refractory symptoms are needed to determine clinical relevance. Acupressure seems to reduce chemotherapy-induced acute nausea severity, though studies did not involve a placebo control. Noninvasive electrostimulation seems unlikely to have a clinically relevant impact when patients are given state-of-the-art pharmacologie antiemetic therapy.

Original languageEnglish (US)
Pages (from-to)7188-7198
Number of pages11
JournalJournal of Clinical Oncology
Volume23
Issue number28
DOIs
StatePublished - 2005
Externally publishedYes

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Acupuncture Points
Nausea
Vomiting
Antiemetics
Acupressure
Electroacupuncture
Drug Therapy
Needles
Emetics
Postoperative Nausea and Vomiting
Magnets
Acupuncture
Electric Stimulation
Placebos
Research Personnel
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Ezzo, J., Vickers, A., Richardson, M. A., Allen, C., Dibble, S. L., Issell, B., ... Zhang, G. (2005). Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting. Journal of Clinical Oncology, 23(28), 7188-7198. https://doi.org/10.1200/JCO.2005.06.028

Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting. / Ezzo, Jeanette; Vickers, Andrew; Richardson, Mary Ann; Allen, Claire; Dibble, Suzanne L.; Issell, Brian; Lao, Lixing; Pearl, Michael; Ramirez, Gilbert; Roscoe, Joseph A.; Shen, Joannie; Shivnan, Jane; Streitberger, Konrad; Treish, Imad; Zhang, Grant.

In: Journal of Clinical Oncology, Vol. 23, No. 28, 2005, p. 7188-7198.

Research output: Contribution to journalReview article

Ezzo, J, Vickers, A, Richardson, MA, Allen, C, Dibble, SL, Issell, B, Lao, L, Pearl, M, Ramirez, G, Roscoe, JA, Shen, J, Shivnan, J, Streitberger, K, Treish, I & Zhang, G 2005, 'Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting', Journal of Clinical Oncology, vol. 23, no. 28, pp. 7188-7198. https://doi.org/10.1200/JCO.2005.06.028
Ezzo J, Vickers A, Richardson MA, Allen C, Dibble SL, Issell B et al. Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting. Journal of Clinical Oncology. 2005;23(28):7188-7198. https://doi.org/10.1200/JCO.2005.06.028
Ezzo, Jeanette ; Vickers, Andrew ; Richardson, Mary Ann ; Allen, Claire ; Dibble, Suzanne L. ; Issell, Brian ; Lao, Lixing ; Pearl, Michael ; Ramirez, Gilbert ; Roscoe, Joseph A. ; Shen, Joannie ; Shivnan, Jane ; Streitberger, Konrad ; Treish, Imad ; Zhang, Grant. / Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting. In: Journal of Clinical Oncology. 2005 ; Vol. 23, No. 28. pp. 7188-7198.
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abstract = "Purpose: Assess the effectiveness of acupuncture-point stimulation on acute and delayed chemotherapy-induced nausea and vomiting in cancer patients. Materials and Methods: Randomized trials of acupuncture-point stimulation by needles, electrical stimulation, magnets, or acupressure were retrieved. Data were provided by investigators of the original trials and pooled using a fixed-effects model. Results: Eleven trials (N = 1,247) were pooled. Overall, acupuncture-point stimulation reduced the proportion of acute vomiting (relative risks [RR] = 0.82; 95{\%} Cl, 0.69 to 0.99; P = .04), but not the mean number of acute emetic episodes or acute or delayed nausea severity compared with controls. By modality, stimulation with needles reduced the proportion of acute vomiting (RR = 0.74; 95{\%} Cl, 0.58 to 0.94; P = .01), but not acute nausea severity. Electroacupuncture reduced the proportion of acute vomiting (RR = 0.76; 95{\%} Cl, 0.60 to 0.97; P = .02), but manual acupuncture did not; delayed symptoms were not reported. Acupressure reduced mean acute nausea severity (standardized mean difference = -0.19; 95{\%} Cl, -0.38 to -0.01 ; P = .03) and most severe acute nausea, but not acute vomiting or delayed symptoms. Noninvasive electrostimulation showed no benefit for any outcome. All trials used concomitant pharmacologic antiemetics, and all, except electroacupuncture trials, used state-of-the-art antiemetics. Conclusion: This review complements data on postoperative nausea and vomiting, suggesting a biologic effect of acupuncture-point stimulation. Electroacupuncture has demonstrated benefit for chemotherapy-induced acute vomiting, but studies with state-of-the-art antiemetics as well as studies for refractory symptoms are needed to determine clinical relevance. Acupressure seems to reduce chemotherapy-induced acute nausea severity, though studies did not involve a placebo control. Noninvasive electrostimulation seems unlikely to have a clinically relevant impact when patients are given state-of-the-art pharmacologie antiemetic therapy.",
author = "Jeanette Ezzo and Andrew Vickers and Richardson, {Mary Ann} and Claire Allen and Dibble, {Suzanne L.} and Brian Issell and Lixing Lao and Michael Pearl and Gilbert Ramirez and Roscoe, {Joseph A.} and Joannie Shen and Jane Shivnan and Konrad Streitberger and Imad Treish and Grant Zhang",
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AU - Ezzo, Jeanette

AU - Vickers, Andrew

AU - Richardson, Mary Ann

AU - Allen, Claire

AU - Dibble, Suzanne L.

AU - Issell, Brian

AU - Lao, Lixing

AU - Pearl, Michael

AU - Ramirez, Gilbert

AU - Roscoe, Joseph A.

AU - Shen, Joannie

AU - Shivnan, Jane

AU - Streitberger, Konrad

AU - Treish, Imad

AU - Zhang, Grant

PY - 2005

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N2 - Purpose: Assess the effectiveness of acupuncture-point stimulation on acute and delayed chemotherapy-induced nausea and vomiting in cancer patients. Materials and Methods: Randomized trials of acupuncture-point stimulation by needles, electrical stimulation, magnets, or acupressure were retrieved. Data were provided by investigators of the original trials and pooled using a fixed-effects model. Results: Eleven trials (N = 1,247) were pooled. Overall, acupuncture-point stimulation reduced the proportion of acute vomiting (relative risks [RR] = 0.82; 95% Cl, 0.69 to 0.99; P = .04), but not the mean number of acute emetic episodes or acute or delayed nausea severity compared with controls. By modality, stimulation with needles reduced the proportion of acute vomiting (RR = 0.74; 95% Cl, 0.58 to 0.94; P = .01), but not acute nausea severity. Electroacupuncture reduced the proportion of acute vomiting (RR = 0.76; 95% Cl, 0.60 to 0.97; P = .02), but manual acupuncture did not; delayed symptoms were not reported. Acupressure reduced mean acute nausea severity (standardized mean difference = -0.19; 95% Cl, -0.38 to -0.01 ; P = .03) and most severe acute nausea, but not acute vomiting or delayed symptoms. Noninvasive electrostimulation showed no benefit for any outcome. All trials used concomitant pharmacologic antiemetics, and all, except electroacupuncture trials, used state-of-the-art antiemetics. Conclusion: This review complements data on postoperative nausea and vomiting, suggesting a biologic effect of acupuncture-point stimulation. Electroacupuncture has demonstrated benefit for chemotherapy-induced acute vomiting, but studies with state-of-the-art antiemetics as well as studies for refractory symptoms are needed to determine clinical relevance. Acupressure seems to reduce chemotherapy-induced acute nausea severity, though studies did not involve a placebo control. Noninvasive electrostimulation seems unlikely to have a clinically relevant impact when patients are given state-of-the-art pharmacologie antiemetic therapy.

AB - Purpose: Assess the effectiveness of acupuncture-point stimulation on acute and delayed chemotherapy-induced nausea and vomiting in cancer patients. Materials and Methods: Randomized trials of acupuncture-point stimulation by needles, electrical stimulation, magnets, or acupressure were retrieved. Data were provided by investigators of the original trials and pooled using a fixed-effects model. Results: Eleven trials (N = 1,247) were pooled. Overall, acupuncture-point stimulation reduced the proportion of acute vomiting (relative risks [RR] = 0.82; 95% Cl, 0.69 to 0.99; P = .04), but not the mean number of acute emetic episodes or acute or delayed nausea severity compared with controls. By modality, stimulation with needles reduced the proportion of acute vomiting (RR = 0.74; 95% Cl, 0.58 to 0.94; P = .01), but not acute nausea severity. Electroacupuncture reduced the proportion of acute vomiting (RR = 0.76; 95% Cl, 0.60 to 0.97; P = .02), but manual acupuncture did not; delayed symptoms were not reported. Acupressure reduced mean acute nausea severity (standardized mean difference = -0.19; 95% Cl, -0.38 to -0.01 ; P = .03) and most severe acute nausea, but not acute vomiting or delayed symptoms. Noninvasive electrostimulation showed no benefit for any outcome. All trials used concomitant pharmacologic antiemetics, and all, except electroacupuncture trials, used state-of-the-art antiemetics. Conclusion: This review complements data on postoperative nausea and vomiting, suggesting a biologic effect of acupuncture-point stimulation. Electroacupuncture has demonstrated benefit for chemotherapy-induced acute vomiting, but studies with state-of-the-art antiemetics as well as studies for refractory symptoms are needed to determine clinical relevance. Acupressure seems to reduce chemotherapy-induced acute nausea severity, though studies did not involve a placebo control. Noninvasive electrostimulation seems unlikely to have a clinically relevant impact when patients are given state-of-the-art pharmacologie antiemetic therapy.

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