Acupuncture for Pain and Dysfunction After Neck Dissection: Results of a Randomized Controlled Trial
David G. Pfister,* Barrie R. Cassileth, Gary E. Deng, K. Simon Yeung, Jennifer S. Lee, Donald Garrity, Angel Cronin, Nancy Lee, Dennis Kraus, Ashok R. Shaha, Jatin Shah, and Andrew J. Vickers
From the Department of Medicine, Sections of Head and Neck Oncology and Integrative Medicine; Department of Epidemiology-Biostatistics; Department of Radiation Oncology; and Department of Surgery, Head and Neck Surgery Service, Memorial Sloan-Kettering Cancer Center, New York, NY.
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Purpose: To determine whether acupuncture reduces pain and dysfunction in patients with cancer with a history of neck dissection. The secondary objective is to determine whether acupuncture relieves dry mouth in this population.
Patients and Methods: Patients at a tertiary cancer center with chronic pain or dysfunction attributed to neck dissection were randomly assigned to weekly acupuncture versus usual care (eg, physical therapy, analgesia, and/or anti-inflammatory drugs, per patient preference or physician recommendation) for 4 weeks. The Constant-Murley score, a composite measure of pain, function, and activities of daily living, was the primary outcome measure. Xerostomia, a secondary end point, was assessed using the Xerostomia Inventory.
Results: Fifty-eight evaluable patients were accrued and randomly assigned from 2004 to 2007 (28 and 30 patients on acupuncture and control arms, respectively). Constant-Murley scores improved more in the acupuncture group (adjusted difference between groups = 11.2; 95% CI, 3.0 to 19.3; P = .008). Acupuncture produced greater improvement in reported xerostomia (adjusted difference in Xerostomia Inventory = –5.8; 95% CI, –0.9 to –10.7; P = .02).
Conclusion: Significant reductions in pain, dysfunction, and xerostomia were observed in patients receiving acupuncture versus usual care. Although further study is needed, these data support the potential role of acupuncture in addressing post–neck dissection pain and dysfunction, as well as xerostomia.