5984 - Clinical characteristics are associated with acupuncture treatment response for xerostomia in cancer patients

Background

Xerostomia is a common symptom in cancer patients undergoing radiation to the head and neck region and/or those undergoing systemic chemotherapy. Acupuncture has been recognized as an effective integrative modality for managing xerostomia, but data about predicting treatment response to acupuncture are limited. We explored patient characteristics and treatment response among patients who received acupuncture for xerostomia.

Methods

We reviewed acupuncture records with a primary referral for xerostomia in an outpatient environment from March 2016 to April 2018. Treatment response was assessed using Edmonton Symptom Assessment Scale (ESAS; 0-10 scale) performed pre and post each acupuncture treatment. Bivariate associations between patient characteristics and treatment response were analyzed.

Results

A total of 781 acupuncture treatment records (139 patients) were identified. Majority were male (63%) and 59 (42%) with head and neck cancer. The median treatment response was 11% (IQR: 0-33) reduction in xerostomia score. BMI ≥ 35 and Charlson comorbidity index (CCI) <6 were associated with greater symptom reduction: BMI ≥ 35 (17% [IQR: 0%-100%]) vs BMI < 35 (10% [IQR: 0%-33%]), P = 0.012; CCI < 6 (14% [IQR: 0%-33%]) vs CCI ≥ 6 (0% [IQR: 0%-25%]), P = 0.003. Mental wellbeing (PROMIS Mental Health score) (P = 0.024) positively correlated with greater reduction in xerostomia score. High severity of fatigue and sleep problems correlated with less symptom reduction (P = 0.008 and P = 0.006, respectively). Higher blood glucose level was associated with less reduction (P = 0.002) in xerostomia score.

Conclusions

Using the current approach, acute pre-post treatment response of xerostomia to acupuncture was low. Features of patient clinical characteristics may be predictive of treatment response. More research is needed to further explore these associations and examine the impact of optimization of clinical conditions on acupuncture treatment response in symptom management for cancer patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.