Recent clinical research from Cangzhou Central Hospital has focused on the integration of acupuncture with the FOLFOX4 chemotherapy regimen for treating advanced gastric cancer. This study provides specific details on the acupuncture techniques, acupoints used, and the outcomes observed, offering practical insights for licensed acupuncturists interested in incorporating acupuncture into cancer care.
Study Protocol and Acupuncture Techniques
The study involved 120 patients with advanced gastric cancer, randomized into two groups: one receiving only the FOLFOX4 chemotherapy regimen and the other receiving FOLFOX4 combined with acupuncture. The chemotherapy regimen consisted of oxaliplatin, 5-fluorouracil, and calcium folinate, administered biweekly over four cycles. Learn more in Prof. Jeffrey Pang's HealthCMi acupuncture continuing educaiton course entitled: Oncology >
Acupuncture Treatment Protocol
- Treatment Frequency: Acupuncture was performed every other day, with each session lasting about 20 minutes. The full course consisted of 28 sessions, synchronized with the chemotherapy schedule.
- Needling Techniques: The acupuncture was performed using millineedles at least 40 mm in length. Two primary needling techniques were employed:
- Lifting-Thrusting Method: This technique was used to modulate the flow of Qi by adjusting the depth and movement of the needle. For tonification, needles were lifted gently, while for sedation, the needles were thrust more deeply.
- Reinforcing-Reducing Method: This involved altering the needle insertion and withdrawal speed to either reinforce or reduce the Qi at the targeted acupoint, depending on the patient’s needs.
- Moxibustion: Moxa sticks were applied over the needle handles at specific points to provide additional thermal stimulation. This practice was particularly useful in points like ST36 and SP15, where improving blood circulation and enhancing the local therapeutic effect was critical.
Acupoints Used
The study highlighted specific acupoints known for their therapeutic roles in managing gastrointestinal function and supporting overall systemic health:
- Guanyuan (CV4): Located on the lower abdomen, CV4 is used for its ability to strengthen Kidney Qi and support core energy, which is often depleted in patients with advanced cancer.
- Qihai (CV6): Positioned below the navel, CV6 is critical for boosting Qi and Blood circulation, particularly in the context of gastrointestinal disorders.
- Zusanli (ST36): This point, located on the leg, is renowned for its role in boosting the immune system and improving digestive health, making it essential in cancer care.
- Daheng (SP15): Found on the abdomen, SP15 is selected for its ability to regulate bowel function, which is often disrupted during chemotherapy.
- Neiguan (PC6): Situated on the inner forearm, PC6 is commonly used to manage nausea and vomiting, common side effects of chemotherapy.
Clinical Outcomes
The study reported several key outcomes, comparing the group receiving acupuncture with the control group:
- Tumor Marker Levels: There was a significant reduction in the levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and CA72-4 in the acupuncture group. Post-treatment CEA levels were reduced to 13.21 µg/ml in the acupuncture group, compared to 16.25 µg/ml in the control group. This suggests that acupuncture may contribute to a more effective response to chemotherapy.
- Quality of Life (QoL): Measured by the MOS 36-item Short Form Health Survey (SF-36), the acupuncture group showed improved scores in physical functioning, vitality, and overall health. The average SF-36 score was 75.23 in the acupuncture group, compared to 68.17 in the control group.
- Adverse Events: The incidence of adverse effects such as nausea, vomiting, and fatigue was lower in the acupuncture group (3.34%) compared to the control group (41.67%). This indicates that acupuncture might play a role in reducing chemotherapy-related toxicities.
Practical Implications for Acupuncturists
This study provides a detailed framework for integrating acupuncture with conventional chemotherapy in the treatment of advanced gastric cancer. Acupuncturists can utilize the specific acupoints and techniques described to potentially improve patient outcomes, reduce the side effects of chemotherapy, and enhance the overall quality of life for patients. By following the treatment protocols and carefully selecting acupoints, practitioners may optimize the therapeutic effects of their interventions. [1]
Conclusion
The combination of acupuncture with the FOLFOX4 chemotherapy regimen appears to offer a promising approach for managing advanced gastric cancer. The detailed protocols used in this study, including specific acupoints and needling techniques, provide a valuable reference for practitioners looking to integrate acupuncture into oncology care. Further research may help refine these techniques and confirm their efficacy in broader clinical settings.
Reference:
1. Xiaomei Miao, et al., “Treatment Alternative and High Safety Profile of Acupuncture Plus Chemotherapy for Advanced Gastric Cancer,” Evidence-Based Complementary and Alternative Medicine, 2022.
