Yun-Fen Li,#1,* De-Quan Liu,#1,* Jian-Yun Nie,#1,* De-Dian Chen,#1,* Mei Yan,1 Zhen Zuo,2 Liang-Xian Liu,3 Wei-Yu Wang,4 Mian-Sheng Zhu,2,5 and Wen-Hui Li1
1The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital, Breast Cancer Surgery Department, Kunming, People’s Republic of China
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1The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital, Breast Cancer Surgery Department, Kunming, People’s Republic of China
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1The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital, Breast Cancer Surgery Department, Kunming, People’s Republic of China
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1The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital, Breast Cancer Surgery Department, Kunming, People’s Republic of China
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1The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital, Breast Cancer Surgery Department, Kunming, People’s Republic of China
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2Yunnan University of Traditional Chinese Medicine, College of Acupuncture, Kunming, People’s Republic of China
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3Kunming Hospital of Traditional Chinese Medicine/The Third Affiliated Hospital of Yunnan University Traditional Chinese Medicine, Acupuncture Department, Kunming, People’s Republic of China
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4Servbus Technology (Beijing) Co., Ltd., Technical Service Department, Beijing, People’s Republic of China
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2Yunnan University of Traditional Chinese Medicine, College of Acupuncture, Kunming, People’s Republic of China
5ARIATAS, Association Pour la Recherche et l’Information de l’Acupuncture Time-Acupoints-Space, College of Acupuncture, Paris, France
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1The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital, Breast Cancer Surgery Department, Kunming, People’s Republic of China
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1The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital, Breast Cancer Surgery Department, Kunming, People’s Republic of China
2Yunnan University of Traditional Chinese Medicine, College of Acupuncture, Kunming, People’s Republic of China
3Kunming Hospital of Traditional Chinese Medicine/The Third Affiliated Hospital of Yunnan University Traditional Chinese Medicine, Acupuncture Department, Kunming, People’s Republic of China
4Servbus Technology (Beijing) Co., Ltd., Technical Service Department, Beijing, People’s Republic of China
5ARIATAS, Association Pour la Recherche et l’Information de l’Acupuncture Time-Acupoints-Space, College of Acupuncture, Paris, France
#Contributed equally.
Correspondence: Mian-Sheng Zhu; Wen-Hui Li Email miansheng@wanadoo.fr; wenhuili2014@163.com
*These authors contributed equally to this work
To investigate the feasibility and effectiveness of ATAS acupuncture (Acupoints-Time-Space Acupuncture) as a non-pharmacological intervention to prevent or relieve chemotherapy-induced fatigue in breast cancer patients undergoing taxane chemotherapy.
A pilot study in Kunming center with the aim of evaluating 40 patients randomized to 3 groups: ATAS, sham and non-acupuncture with an unequal randomization of 2:1:1. Participants with stage I–III breast cancer were scheduled to receive adjuvant EC4P4 chemotherapy. Participants in the ATAS and sham acupuncture arms received 20 sessions of acupuncture over 20 weeks, non-acupuncture arm received usual care. Evaluation scales, including VAS-F, MFI-20, HDAS, ISI, and blood samples were collected at four timepoints (T1-T4). mRNA sequencing was performed to detect the mechanism of acupuncture.
A total of 581 sessions of acupuncture were performed on patients in the acupuncture group. There was no difference between the three groups in terms of clinical characteristics. Patients randomized to ATAS acupuncture had improved symptoms including fatigue, anxiety and insomnia during the whole process of chemotherapy compared with the other two groups. The VAS-F score of ATAS acupuncture group was decreased compared with non-acupuncture group (P=0.004). The score of MFI-20 in ATAS acupuncture group was kept at low level, while the other two groups’ scores kept climbing during chemotherapy (P=0.016; P=0.028, respectively). The mechanism of ATAS acupuncture which reduced fatigue and depression may be related to ADROA1, by regulating cGMP/PKG pathway.
This pilot study has demonstrated that ATAS acupuncture can significantly reduce fatigue induced by chemotherapy.
Chinese Clinical Trials Registry, ChiCTR-IPR-17,013,652, registered Dec 3, 2017. http://www.chictr.org.cn/.
Version 3.2 dated from 2018/04/20.
Keywords: early stage breast cancer, adjuvant chemotherapy, chemotherapy induced fatigue, ATAS