Efficacy of acupuncture in the prevention and treatment of chemotherapy-induced nausea and vomiting in patients with advanced cancer: a multi-center, single-blind, randomized, sham-controlled clinical research

Acupuncture represents an ancient therapeutic approach that has gained increasing recognition in the Western world as a complementary treatment for various cancer-related symptoms. Among the most distressing side effects of chemotherapy are nausea and vomiting, which significantly affect patients' quality of life and may compromise their adherence to cancer treatment. Although modern antiemetic medications have revolutionized the control of these symptoms, many patients still experience nausea and vomiting, especially during the delayed phase after chemotherapy. Nausea, in particular, remains a challenging symptom to control, often being more persistent and bothersome than vomiting itself.

This multicenter, randomized, controlled study was conducted to investigate the efficacy of true acupuncture compared to sham acupuncture in controlling chemotherapy-induced nausea and vomiting in patients with advanced cancer. The research involved 134 participants divided into two groups: 68 received true acupuncture and 66 received sham acupuncture. Patients included in the study had a diagnosis of lung, breast, or gynecologic cancer and were scheduled to receive chemotherapy based on cisplatin, anthracycline, or taxanes. Treatment consisted of acupuncture sessions delivered twice on the first day of chemotherapy and once daily on the following four days.

True acupuncture used specific traditional Chinese medicine points, including electrical stimulation, while sham acupuncture used points without therapeutic significance in Chinese medicine, with superficial needle insertion.

The results revealed that, although true acupuncture did not demonstrate significant superiority in complete control rates of nausea and vomiting, it showed important benefits in reducing the intensity of these symptoms. Starting on the third day after chemotherapy initiation, patients who received true acupuncture had lower nausea intensity compared to the control group, with this difference remaining statistically significant until the end of the 21-day observation period. For vomiting, benefits became evident from the seventh day onward, also persisting until the end of the study. Additionally, patients treated with true acupuncture demonstrated better recovery of nutritional status, evidenced by significantly higher scores on appetite questionnaires administered on days 14 and 21 after chemotherapy initiation.

These findings have relevant clinical implications for both patients and healthcare professionals. For patients, the results suggest that acupuncture may be a valuable strategy as a complementary treatment, especially for those who continue to face persistent nausea and vomiting despite the use of conventional antiemetic medications. The improvement in nutritional status is particularly important, as adequate maintenance of nutrition during cancer treatment is directly related to the ability to tolerate chemotherapy and to clinical outcomes. For clinicians, the study provides evidence that acupuncture should be considered as part of an integrated approach to managing chemotherapy side effects, especially in cases where conventional methods do not provide satisfactory symptom control.

It is important to acknowledge the limitations of this study for an adequate interpretation of the results. Although it was a controlled study, the absence of a control group without any intervention limits the ability to fully distinguish the specific effects of acupuncture from possible physiological effects of sham acupuncture. In addition, some participants dropped out of the study for various reasons, which may have influenced the results. Slower-than-expected recruitment also represented a challenge, reflecting possible practical barriers to implementing acupuncture studies in clinical oncology settings.

Despite these limitations, the study offers encouraging evidence that acupuncture may be a useful tool in the therapeutic arsenal for improving cancer patients' quality of life, particularly in controlling the intensity of nausea and vomiting and promoting nutritional recovery during chemotherapy treatment.