Acupuncture should be considered as a preventive measure for radiation-induced dry mouth in patients undergoing radiation therapy for head and neck cancer, based on the findings of a new study published on December 6 in JAMA Network Open.
Patients with head and neck cancer who received acupuncture treatments three times per week while undergoing radiation therapy experienced less dry mouth symptoms up to 12 months after cancer treatment, the researchers found.
"These findings suggest that acupuncture should be considered for the prevention of radiation-induced xerostomia," wrote the authors, led by M. Kay Garcia, DrPH, of the department of palliative, rehabilitation, and integrative medicine at the University of Texas MD Anderson Cancer Center in Houston.
Dry mouth is a common, serious concern, affecting up to 80% of head and neck cancer patients by the end of radiation treatment. Previous research has already shown that acupuncture can help. Acupuncture treatment has very few side effects and is relatively lower in cost compared with standard treatments such as medication and saliva substitutes. Therefore, researchers used the trial to evaluate its use during radiation therapy to reduce the incidence and severity of radiation-induced dry mouth, the authors wrote.
The study included 339 head and neck cancer patients undergoing radiation treatment at MD Anderson Cancer Center and Fudan University Cancer Center in Shanghai between December 2011 and July 2015. None of the participants had received acupuncture prior to the study.
Patients who received the alternative treatments for this study were given acupuncture three days a week on the same day as their radiation treatments, which lasted six to seven weeks. The researchers gathered data from self-reported questionnaires that patients completed at baseline, after radiation, and three, six, and 12 months after cancer treatments. Scores under 30 corresponded to mild or no xerostomia symptoms.
Patients who received acupuncture had significantly lower xerostomia scores than those who underwent standard care control, which included radiation and oral health education. One year after the end of radiation therapy, the incidence of clinically significant xerostomia was 35% in patients who received acupuncture and 55% in those who didn't.
Those who received acupuncture had significantly fewer and less severe dry mouth symptoms, with xerostomia scores of about 27 one year after treatment. The xerostomia score was about 35 in those who didn't.
Though the researchers found acupuncture to be superior to standard care in relieving symptoms of dry mouth caused by radiation, the study had some limitations, including that researchers did not systematically collect data on the use of salivary substitutes. Patients needed to refrain from using substitutes 24 hours before data collection. However, if patients took them, it was unlikely to affect the findings since salivary substitutes only last about four hours, the authors noted.
Though acupuncture is cost-effective, minimally invasive, and has a very low incidence of adverse effects, further studies are needed to confirm the clinical relevance and generalizability of the findings, they added.
"Acupuncture may be considered an adjunct to standard care for patients who are interested in receiving acupuncture and at risk of developing [radiation-induced xerostomia]," the authors wrote.