Acupuncture vs Massage for Pain in Patients Living With Advanced Cancer

• DOI: 10.1001/jamanetworkopen.2023.42482
• Publication Date: 2023-11-14T16:17:17Z
• Authors: Andrew S. Epstein; Kevin T. Liou; Sally A. D. Romero; Raymond E. Baser; Greta Wong; Han Xiao; Zunli Mo; Desiree Walker; Jodi MacLeod; Qing Li; Margaret Barton-B...; Gary E. Deng; Katherine S. Pana...; John T. Farrar; Jun J. Mao
• Keywords: Pain medicine; Brief Pain Inventory

Importance Pain is challenging for patients with advanced cancer. While recent guidelines recommend acupuncture and massage cancer pain, their comparative effectiveness unknown. Objective To compare the effects of on musculoskeletal pain among Design, Setting, Participants A multicenter pragmatic randomized clinical trial was conducted at US care centers consisting a northeastern comprehensive center southeastern institute from September 19, 2019, through February 23, 2022. The principal investigator study statisticians were blinded to treatment assignments. duration follow-up 26 weeks. Intention-to-treat analyses performed (linear mixed models). included moderate severe clinician-estimated life expectancy 6 months or more. Patient recruitment strategy multipronged (eg, patient database queries, mailings, referrals, community outreach). Eligible had English Spanish as first language, older than 18 years, Karnofsky score greater equal 60 (range, 0-100; higher scores indicating less functional impairment). Interventions Weekly 10 weeks monthly booster sessions up Main Outcomes Measures primary end point change in worst intensity baseline secondary outcomes fatigue, insomnia, quality life. Brief Inventory 0-10; numbers indicate worse interference) used measure outcome. Results total 298 participants enrolled (mean [SD] age, 58.7 [14.1] 200 [67.1%] women, 33 [11.1%] Black, 220 [74.1%] White, 46 [15.4%] Hispanic, 78.5% solid tumors). mean (SD) 6.9 (1.5). During weeks, reduced score, −2.53 (95% CI, −2.92 −2.15) points, −3.01 −3.38 −2.63) points; between-group difference not significant (−0.48; 95% −0.98 0.03; P = .07). Both treatments also improved without differences. Adverse events mild bruising (6.5% receiving acupuncture) transient soreness (15.1% massage). Conclusions Relevance In this cancer, both associated reduction over weeks; however, there no different between treatments. More research needed evaluate how best integrate these approaches into optimize symptom management growing population people living Trial Registration ClinicalTrials.gov Identifier: NCT04095234