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Electro-acupuncture versus battle field auricular acupuncture in breast cancer survivors with chronic musculoskeletal pain: subgroup analysis of a randomized clinical trial

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Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Chronic musculoskeletal pain is common and debilitating among breast cancer survivors. The PEACE trial demonstrated that electro-acupuncture (EA) and battle field auricular acupuncture (BFAA) both reduced pain more than usual care (UC) in cancer survivors. However, the comparative effectiveness between EA and BFAA among breast cancer survivors is unknown.

Methods

EA and BFAA received ten weekly treatments. UC was offered ten EA treatments after week 12. The primary endpoint was change in mean Brief Pain Inventory (BPI) pain severity from baseline to week 12. We analyzed the subset of 165 (46%) trial participants with a breast cancer primary diagnosis. We conducted constrained linear mixed model analyses, which constrained all arms to a common pre-randomization baseline mean. Model-based mean estimates at weeks 12 and 24 were compared between arms using model contrasts.

Results

Among 165 breast cancer survivors, common pre-randomization mean pain severity was 5.35 [95% Confidence Interval (CI) 5.04, 5.66]. At week 12, BPI pain severity score was 2.69 (2.26. 3.13) in EA, 3.60 (3.17, 4.02) in BFAA, and 5.06 (4.47, 5.65) in UC. EA reduced pain severity significantly more than BFAA at weeks 12 [− 0.90 (− 1.45, − 0.36), p = 0.001] and 24 [− 0.82, (− 1.38, − 0.27), p = 0.004]. EA and BFAA significantly improved both Patient-Reported Outcomes Measurement Information System (PROMIS) – Global Health physical health and mental health component scores at week 12 compared to UC. Mild toxicities were reported.

Conclusion

EA was more effective than BFAA at reducing pain severity, but both similarly improved physical and mental health scores. Breast cancer survivors with chronic musculoskeletal pain may consider EA before BFAA.

Trial registration

ClinicalTrials.gov Identifier: NCT02979574. https://clinicaltrials.gov/ct2/show/NCT02979574

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the Department of Defense office of the Congressionally Directed Medical Research Programs through the Peer Reviewed Medical Research Program Clinical Trial Award (W81XWH-15-1-0245). This work was also supported in part by a National Institutes of Health/National Cancer Institute (NIH/NCI) Cancer Center Support Grant P30 CA008748 to Memorial Sloan Kettering Cancer Center. Dr. Bao is supported in part by NCI R37 CA248563. Dr. Mao is supported in part by NCI 1 R01 CA240417. Dr. Gillespie is supported in part by NCI K08 CA252640.

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Authors and Affiliations

  1. Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Ting Bao, Q. Susan Li, Matthew Weitzman & Jun J. Mao

  2. Breast Medicine Service, Solid Tumor Division, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Ting Bao, W. Iris Zhi & Mark Robson

  3. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Raymond E. Baser

  4. Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA

    Erin F. Gillespie

  5. Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 E. 61st Street, 4th Floor, New York, NY, 10065, USA

    Ting Bao

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  1. Ting Bao
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Contributions

The conception or design of the work: TB, JM; The acquisition, analysis, or interpretation of data: All authors; Drafted the work or substantively revised it: TB, IZ. All authors approved the submitted version (and any substantially modified version that involves the author’s contribution to the study). All authors have agreed both to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

Corresponding author

Correspondence to Ting Bao.

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Conflict of interest

Jun J. Mao reports research funding provided to Memorial Sloan Kettering Cancer Center from Tibet Cheezheng Tibetan Medicine Company, Ltd. outside the submitted work. Ting Bao reports a consultation role in Eisai Inc.

Ethical approval

The Institutional Review Board at Memorial Sloan Kettering Cancer Center approved the trial protocol, and the study followed the Consolidated Standards of Reporting Trials (CONSORT) reporting guidelines. The trial registration records are available at ClinicalTrials.gov, identifier: NCT02979574, https://clinicaltrials.gov/ct2/show/NCT02979574.

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Informed consent was obtained from all individual participants included in the study.

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Bao, T., Zhi, W.I., Baser, R.E. et al. Electro-acupuncture versus battle field auricular acupuncture in breast cancer survivors with chronic musculoskeletal pain: subgroup analysis of a randomized clinical trial. Breast Cancer Res Treat 202, 287–295 (2023). https://doi.org/10.1007/s10549-023-07072-1

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