Delayed Chemotherapy Nausea/Emesis: Electroacupuncture

延迟化疗恶心/呕吐：电针

• 批准号: 6959217
• 负责人: Patrick J Mansky
• 金额: --
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6959217
• 关键词: Ewing' s tumor; acupuncture /acupressure; adolescence (12-20); alternative medicine; antiemetics; biomarker; clinical trials; drug adverse effect; electrical property; emesis; human subject; human therapy evaluation; immune system; nausea; neoplasm /cancer chemotherapy; neuroendocrine system; osteosarcoma; patient care management; patient oriented research; pediatric neoplasm /cancer; quality of life; stress management; young adult human (21-34)

Acupuncture and electroacupuncture at the P6 point in the wrist and the St 36 point in the anterior tibialis muscle have been been reported to be effective in reducing nausea and emesis occurring acutely (less than 24 hours) after chemotherapy. Although acute chemotherapy-induced nausea and emesis can be also be effectively treated with contemporary pharmacologic anti-emetic regimens, delayed nausea (more than 24 hours to 5 days) after chemotherapy continues to be a clinical management challenge. Patients diagnosed with pediatric-type sarcomas can be successfully treated using a comprehensive approach that includes highly emetogenic multi-agent chemotherapy. Delayed nausea is often managed by recurrent administration of high dose corticosteroids, with suboptimal therapeutic benefit and frequent undesirable side effects, such as weight gain, growth retardation and increased risk for infections. Recurrent or delayed nausea, in addition to its negative effect on Quality of Life (QOL), may constitute a state of stress for the affected patient, contributing to adverse endocrine, metabolic and immunologic sequelae. Mechanisms of activity of acupuncture in the treatment of acute nausea and emesis have not been clarified. We have initiated a study to determine whether electroacupuncture is effective in the treatment of chemotherapy-induced delayed nausea and emesis in patients with pediatric-type sarcomas, resulting in improved management of these symptoms and enhanced QOL. We also aim to identify whether acupuncture reduces the stressor state of these chemotherapy-treated patients, reversing its negative effects on the neuro-endocrine and immune systems. Using a randomized, blinded design with control, sham needling, we shall study a total of 52 chemotherapy-naive patients with pediatric-type sarcomas, age 16-35 years, who will be enrolled for two electroacupuncture treatment periods of 7 days each during the first two chemotherapy cycles. 5 Study subjects have been enrolled to date: Ewing's sacroma:4, osteosarcoma: 1. 4 of 5 completed the study , one subject left the study after cycle 1.

据报道，腕部肌肉的P6点的针灸和电针刺据报道，胫骨前肌的ST 36点有效减少恶心，化学疗法后急性（小于24小时）发生呕吐。尽管急性化学疗法引起的恶心和呕吐也可以通过当代药理抗雌激素方案有效治疗，但化学疗法后的恶心延迟（超过24小时至5天）继续是临床管理挑战。诊断为儿科肉瘤的患者可以使用包括高度突出的多药化学疗法的综合方法成功治疗。延迟的恶心通常通过反复施用高剂量皮质类固醇，具有次优的治疗益处和频繁的不良副作用，例如体重增加，增长迟缓和感染风险增加。除了对生活质量的负面影响（QOL）外，复发性或延迟的恶心还可能构成受影响患者的压力状态，从而导致内分泌，代谢和免疫后遗症。尚未澄清针灸治疗中针灸活性的机制。我们已经开始了一项研究，以确定电针作是否有效治疗小儿型肉瘤患者的化学疗法引起的延迟恶心和屈服，从而改善了这些症状和增强QOL的治疗。我们还旨在确定针灸是否减少了这些化学疗法治疗的患者的压力源状态，从而扭转了其对神经内分泌和免疫系统的负面影响。使用对照，假针的随机，盲目设计，我们将总共研究52例儿童型肉瘤，年龄在16-35岁的儿科型肉瘤患者中，他们将在两个电针治疗期间招募7天，为期7天前两个化学疗法周期。 5名研究对象迄今已招募：尤因的sar瘤：4，骨肉瘤：1。4of 5完成了研究，一名受试者在周期1之后离开了研究。