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Sub-category:
Head and Neck Cancer
Category:
Head and Neck Cancer
Meeting:
2008 ASCO Annual Meeting
Abstract No:
6016
Citation:
J Clin Oncol 26: 2008 (May 20 suppl; abstr 6016)
Author(s):
D. Pfister, A. Vickers, G. Deng, J. S. Lee, D. Garrity, N. Lee, D. Kraus, A. Shaha, J. Shah, B. R. Cassileth
Abstract:
Background: Standard treatments for pain/dysfunction after neck dissection (ND) for cancer often have disappointing efficacy. Acupuncture (AC) has demonstrated benefits in randomized trials for treating chronic musculoskeletal pain, including in the neck and shoulder. Uncontrolled trials suggest AC to be of potential benefit for xerostomia relief. Methods: Eligible patients (pts) were >3 months post ND and radiation; had pain/dysfunction [Constant-Murley (CM) score <70] attributed to ND. Pts were randomized to weekly AC versus usual care (eg, physical therapy, analgesia, and/or anti-inflammatory drugs, per patient preference/physician recommendation) for 4 weeks. To address both efficacy and reproducibility, standard and optional AC points were used. The primary endpoint was pain/dysfunction as measured by CM score (0-100, higher is better). The secondary endpoint of xerostomia relief was measured by the Xerostomia Inventory (XI, normalized to a 0-100 scale, lower is better). Results: 70 pts were randomized to either AC (n=34) or control (n=36). Median age: 59 years; female/male: 26/44; modified radical ND: 83%; squamous cell carcinoma: 60%. Endpoint data were incomplete in 12 pts, the most common reason being failure to complete their final assessment (6 of 12 pts, 3 on each arm). Mean baseline CM scores (AC: 41.9 versus usual care: 45.0) improved more in the AC group (difference between groups 11.0; 95% Confidence Interval (CI) 2.9, 19.2; p=0.009). More pts responded to treatment (33% or more improvement in CM score) in the AC group (39% versus 7%, p=0.004). AC produced greater improvement in reported xerostomia (difference in XI 5.8; 95% CI 0.9, 10.7; p=0.021), a benefit that persisted even when the analysis was limited to pts with high baseline scores. Conclusion: Significant reductions in pain, dysfunction, and xerostomia were observed in pts receiving AC versus usual care. Although further study is needed, these data support the potential role of AC in addressing post-ND pain and dysfunction, as well as xerostomia. (Supported by CA098792).
Abstract Disclosures
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy
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Educational Book Manuscripts by D. Pfister :
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