Effect of Acupuncture on Delayed Emesis for the Patients Who Received High-Emetogenic Chemotherapy with Standard Antiemetic Prophylaxis (KHMC-HO-01): An Open-Label, Randomized Study

Abstract

Background. Chemotherapy-induced nausea and vomiting (CINV) is one of the most important issues associated with chemotherapy. The additional or synergistic effect of acupuncture on CINV remains controversial. Methods. Patients were randomized into either the group that received standard antiemetics with acupuncture (Arm A) or standard antiemetics only (Arm C). Acupuncture with manual stimulation was applied at eight predefined points and was started before the first cycle of chemotherapy on the first day and two additional sessions were administered on the second day of chemotherapy. Acute and delayed CINV was assessed using the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) and the MASCC Antiemesis Tool (MAT). The primary outcome was the delayed nausea score assessed using the RINVR. Results. Overall, 42 patients were included. In the delay phase, the severity of delayed nausea was slightly lower without significance in Arm A than in Arm C (5.35 vs. 5.98, $p$  = 0.3011). Similarly, patients in Arm A reported less severe vomiting than those in Arm C (0.75 vs. 1.25, $p$  = 0.3064). Delayed nausea and vomiting assessed by the MAT showed significant relief with acupuncture compared to standard antiemesis alone. In terms of acute emesis, there was no significant difference between the two arms according to either scoring method. Conclusions. Delayed nausea after HEC tended to decrease with acupuncture using the RINVR score, though it was also not significant. With the MAT assessment, delayed emesis (nausea and vomiting) was significantly improved with acupuncture, suggesting a promising effect of acupuncture. This trial is registered with KCT0006477.