Acupuncture helps radiotherapy-induced xerostomia concludes an American research team. They found it more effective than standard oral hygiene, for patients who had been undergoing treatment for head and neck cancer.
The team identified 258 patients, mean age 65, experiencing xerostomia after their therapy, and divided them into three groups: true acupuncture, sham control acupuncture and standard oral hygiene (mouth rinses, lip balms, hydration etc). Acupuncture was given twice a week for four weeks, plus an additional four weeks for patients showing a minor response. Treatments were administered at 33 centres across 12 states.
At week four, the true acupuncture group showed significantly lower xerostomia and higher quality of life scores than either of the other two groups. At the week 4 point, 31% of patients receiving true acupuncture had received a partial treatment response. This compared with 17% and 14% for sham acupuncture and standard care respectively. Differences between true acupuncture and standard care remained at week 12 follow-up.
The sham acupuncture group improved over time but took until week 26 to show a significant difference from standard care. By this time, there were no longer any significant differences between the true and sham acupuncture groups.
The authors conclude that acupuncture is minimally invasive and inexpensive, has a low incidence of adverse effects, and was found to be superior to standard care. They go on to say that although acupuncture mechanisms are not well understood, findings from multiple studies suggest possible central nervous system effects through manipulation of the fascia. Studies have revealed significantly increased blood flow in the skin of the cheek of patients with xerostomia. Other plausible hypotheses suggest that increased production of certain neuropeptides after acupuncture stimulation may cause vasodilation and increased microcirculation. Research has explored neuronal substrates during acupuncture, using functional magnetic resonance imaging. True acupuncture was associated with activation of areas of the brain where sensory stimuli and expectation/suggestion signals are integrated, an effect not seen with sham treatment.
(Acupuncture for Chronic Radiation-Induced Xerostomia in Head & Neck Cancer: A Multicenter Randomized Clinical Trial. Journal of the American Medical Association Network Open, 13 May 2024.)