Nada Lukkahatai, Yannuo Jiang, Jingyu Zhang, Jennifer Kawi, Hulin Wu, Hongyu Wang, Claudia M Campbell, Johannes Thrul, Salahadin Abdi, Eileen D Hacker, Constance M Johnson, Thomas J Smith
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引用次数: 0
Abstract
Purpose: Chemotherapy-induced neuropathy (CIN) is a persistent condition that impairs function and quality of life. Auricular point acupressure (APA) has shown short-term benefit for CIN, but the durability of these effects after treatment completion is unknown. This study evaluated the sustainability of symptom improvements for 3 months following a 4-week APA intervention.
Methods: This prespecified secondary analysis of a randomized wait-list controlled trial compared mobile-supported APA (mAPA) and virtual APA (vAPA) in adults with moderate or greater CIN who received APA during the initial treatment phase (mAPA, n = 80; vAPA, n = 75). Outcomes at 1, 2, and 3 months post-intervention were analyzed using generalized estimating equations with multiple imputation. The primary outcome was CIN severity, measured with an individualized composite outcome (ICO); the secondary outcome was CIN interference.
Results: Reductions in CIN severity and interference were maintained throughout follow-up in both groups (all p < .001). ICO scores decreased by 3.10, 3.36, and 3.61 points in mAPA and by 2.88, 2.90, and 3.21 points in vAPA at 1, 2, and 3 months, respectively. Benefits were maintained post-treatment, with higher retention in the mAPA group.
Conclusions: Improvements in CIN severity and interference after APA were sustained for up to 3 months post-treatment, suggesting a durable benefit as a self-management strategy. Larger studies with longer follow-up and untreated comparison groups are needed.
Implications for cancer survivors: APA may offer survivors a durable, self-administered, nonpharmacologic option for managing CIN well beyond active treatment, without requiring ongoing clinical visits.
Trial registration: ClinicalTrials.gov, ID NCT04920097 registered on 3 June 2021.
目的：化疗诱导的神经病变（CIN）是一种损害功能和生活质量的持续性疾病。耳穴穴位按压（APA）对CIN有短期益处，但治疗完成后这些效果的持久性尚不清楚。本研究评估了4周APA干预后3个月症状改善的可持续性。方法：这项预先指定的随机等待名单对照试验的二次分析比较了在初始治疗阶段接受APA的中度或更严重CIN成人（mAPA, n = 80; vAPA, n = 75）的移动支持APA （mAPA）和虚拟APA （vAPA）。干预后1个月、2个月和3个月的结果使用多重imputation广义估计方程进行分析。主要结局是CIN的严重程度，用个体化综合结局（ICO）来衡量；次要结局为CIN干扰。结果：在整个随访过程中，两组的CIN严重程度和干扰都保持了降低（均为p）。结论：APA后CIN严重程度和干扰的改善持续了治疗后3个月，表明作为自我管理策略具有持久的益处。需要更大的研究，更长的随访时间和未经治疗的对照组。对癌症幸存者的启示：APA可能为幸存者提供一种持久的、自我管理的、非药物的选择，可以在积极治疗之外很好地管理CIN，而不需要持续的临床访问。试验注册：ClinicalTrials.gov，编号NCT04920097，于2021年6月3日注册。
期刊介绍：
Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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