Reindl, T.K., Geilen, W., Hartmann, R., Wiebelitz, K.R., Kan, G., Wilhelm, I., . . . Driever, P.H. (2006). Acupuncture against chemotherapy-induced nausea and vomiting in pediatric oncology. Interim results of a multicenter crossover study. Supportive Care in Cancer, 14, 172–176. 

DOI Link

Study Purpose

To evaluate the efficacy and acceptability of acupuncture in pediatric oncology patients receiving highly emetogenic chemotherapy (HEC) as an adjunct to standard antiemetic therapy

Intervention Characteristics/Basic Study Process

Prior to the initiation of HEC, pediatric patients were randomized to either antiemetic medications alone or antiemetic medications with acupuncture. Patients received standard antiemetics for all cycles (5HT3 with or without dexamethasone and IV phenothiazine). Acupuncture was given on day 1 of chemotherapy and on subsequent days on demand. The first two courses of chemotherapy were included in the study.

Sample Characteristics

  • N = 5
  • MEDIAN AGE = 14.5 years (range = 15–16.8)
  • MALES: 20%, FEMALES: 80%
  • KEY DISEASE CHARACTERISTICS: Treated for sarcoma

Setting

  • SITE: Multi-site    
  • SETTING TYPE: Not specified  
  • LOCATION: Witten, Germany

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment
  • APPLICATIONS: Pediatrics

Study Design

Quasi-experimental, crossover design

Measurement Instruments/Methods

  • Patients' diaries noted why they chose to continue the intervention (acupuncture).
  • Determined if patients were able to reduce the amount of antiemetic medication taken during subsequent courses of chemotherapy without breakthrough chemotherapy-induced nausea and vomiting

Results

Patients receiving acupuncture perceived that they had reduced chemotherapy-related side effects and higher levels of mental alertness.

Conclusions

Episodes of nausea and vomiting were not statistically different with or without acupuncture. One patient experienced pain during needling.

Limitations

  • Small sample (< 30)
  • Risk of bias (no blinding)
  • Risk of bias (no random assignment)
  • Measurement/methods not well described
  • Measurement validity/reliability questionable
  • Subject withdrawals ≥ 10%  
  • Other limitations/explanation: Extremely small number of patients

Nursing Implications

Pediatric patients receiving HEC may be open to acupuncture to reduce chemotherapy-induced nausea and vomiting in addition to standard antiemetic therapy. More research needs to be done to validate its benefit.