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The standardization of acupuncture treatment for radiation-induced xerostomia: A literature review

  • Literature Research
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Chinese Journal of Integrative Medicine Aims and scope Submit manuscript

Abstract

Objective

To assess the relative standardization of acupuncture protocols for radiation-induced xerostomia.

Methods

A literature search was carried out up to November 10, 2012 in the databases PubMed/MEDLINE, EMBASE and China National Knowledge Infrastruction with the terms: radiation-induced xerostomia, acupuncture, acupuncture treatment, and acupuncture therapy. Five ancient Chinese classic acupuncture works were also reviewed with the keywords "dry mouth, thirst, dry tongue, dry eyes and dry lips" to search the effective acupuncture points for dry mouth-associated symptoms in ancient China.

Results

Twenty-two full-text articles relevant to acupuncture treatment for radiation-induced xerostomia were included and a total of 48 acupuncture points were searched in the 5 ancient Chinese classic acupuncture works, in which the most commonly used points were Chengjiang (CV24), Shuigou (GV 26), Duiduan (GV 27), Jinjin (EX-HN 12), and Yuye (EX-HN 13) on head and neck, Sanjian (LI 3), Shangyang (LI 1), Shaoshang (LU 11), Shaoze (SI 1), Xialian (LI 8) on hand, Fuliu (KI 7), Dazhong (KI 4), Zuqiaoyin (GB 44), Taichong (LR 3), Zhaohai (KI 6) on foot, Burong (ST 19), Zhangmen (LR 13), Tiantu (CV 22), Qimen (LR 14) on abdomen, Feishu (BL 13), Danshu (BL 19), Xiaochaogshu (BL 27), Ganshu (BL 18) on back, Shenmen (TF 4), Shen (CO10, Kidney), Yidan (CO11, Pancreas) and Pi (CO13, Spleen) on ear.

Conclusion

There were considerable heterogeneities in the current acupuncture treatment protocols for radiation-induced xerostomia. Based on the results of the review and the personal perspectives, the authors provide a recommendation for manual acupuncture protocols in treating radiationinduced xerostomia patients with head and neck cancer.

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References

  1. Lu WD, Rosenthal DS. Recent advances in oncology acupuncture and safety considerations in practice. Curr Treatm Options Oncol 2010;11:141–146.

    Article  Google Scholar 

  2. Bhide SA, Miah AB, Harrington KJ, Newbold KL, Nutting CM. Radiation-induced xerostomia: pathophysiology, prevention and treatment. Clin Oncol 2009;21:737–744.

    Article  CAS  Google Scholar 

  3. Maes A, Weltens C, Flamen P, Lambin P, Bogaerts R, Liu X, et al. Preservation of parotid function with uncomplicated conformal radiotherapy. Radioth Oncol 2002;63:203–211.

    Article  Google Scholar 

  4. Vergeer MR, Doornaert PA, Rietveld DH, Leemans CR, Slotman BJ, Langendijk JA. Intensity-modulated radiotherapy reduces radiation-induced morbidity and improves health-related quality of life: results of a nonrandomized prospective study using a standardized follow-up program. Int J Radiat Oncol Biol Physics 2009;74:1–8.

    Article  Google Scholar 

  5. Chen WC, Hwang TZ, Wang WH, Lu CH, Chen CC, Chen CM, et al. Comparison between conventional and intensitymodulated post-operative radiotherapy for stage I and II oral cavity cancer in terms of treatment results and toxicity. Oral Oncol 2009;45:505–510.

    Article  PubMed  Google Scholar 

  6. Wasserman TH, Brizel DM, Henke M, Monnier A, Eschwege F, Sauer R, et al. Influence of intravenous amifostine on xerostomia, tumor control, and survival after radiotherapy for head-and-neck cancer: 2-year follow-up of a prospective, randomized, phase I trial. Int J Radiat Ooncol Biol Physics 2005;63:985–990.

    Article  CAS  Google Scholar 

  7. Scarantino C, LeVeque F, Swann RS, White R, Schulsinger A, Hodson DI, et al. Effect of pilocarpine during radiation therapy: results of RTOG 97-09, a phase I randomized study in head and neck cancer patients. J Support Oncol 2006;4:252–258.

    CAS  PubMed  Google Scholar 

  8. Blom M, Lundeberg T. Long-term follow-up of patients treated with acupuncture for xerostomia and the influence of additional treatment. Oral Dis 2000;6:15–24.

    Article  CAS  PubMed  Google Scholar 

  9. Blom M, Dawidson I, Angmar-Mansson B. Acupuncture treatment of xerostomia caused by irradiation of the head and neck region: case reports. J Oral Rehab 1993;20:491–494.

    Article  CAS  Google Scholar 

  10. Blom M, Dawidson I, Angmar-Mansson B. The effect of acupuncture on salivary flow rates in patients with xerostomia. Oral Surg Oral Med Oral Pathol 1992;73:293–298.

    Article  CAS  PubMed  Google Scholar 

  11. Blom M, Dawidson I, Fernberg JO, Johnson G, Angmar-Mansson B. Acupuncture treatment of patients with radiation-induced xerostomia. Eur J Cancer Part B Oral Oncol 1996;32B:182–190.

    Article  CAS  Google Scholar 

  12. Blom M, Kopp S, Lundeberg T. Prognostic value of the pilocarpine test to identify patients who may obtain longterm relief from xerostomia by acupuncture treatment. Arch Otolaryngol Head Neck Surg 1999;125:561–566.

    Article  CAS  PubMed  Google Scholar 

  13. Braga FP, Lemos JCA, Alves FA, Migliari DA. Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer. Brazil Oral Res 2011;25:180–185.

    Article  Google Scholar 

  14. Cho JH, Chung WK, Kang W, Choi SM, Cho CK, Son CG. Manual acupuncture improved quality of life in cancer patients with radiation-induced xerostomia. J Altern Complement Med 2008;14:523–526.

    Article  PubMed  Google Scholar 

  15. Dawidson I, Angmar-Mansson B, Blom M, Theodorsson E, Lundeberg T. Sensory stimulation (acupuncture) increases the release of calcitonin gene-related peptide in the saliva of xerostomia sufferers. Neuropeptides 1999;33:244–250.

    Article  CAS  PubMed  Google Scholar 

  16. Dawidson I, Angmar-Mansson B, Blom M, Theodorsson E, Lundeberg T. Sensory stimulation (acupuncture) increases the release of vasoactive intestinal polypeptide in the saliva of xerostomia sufferers. Neuropeptides 1998;32:543–548.

    Article  CAS  PubMed  Google Scholar 

  17. Garcia MK, Chiang JS, Cohen L, Liu M, Palmer JL, Rosenthal DI, et al. Acupuncture for radiation-induced xerostomia in patients with cancer: a pilot study. Head Neck 2009;31:1360–1368.

    Article  PubMed  Google Scholar 

  18. Johnstone PA, Peng YP, May BC, Inouye WS, Niemtzow RC. Acupuncture for pilocarpine-resistant xerostomia following radiotherapy for head and neck malignancies. Int J Radiat Ooncol Biol Physics 2001;50:353–357.

    Article  CAS  Google Scholar 

  19. Johnstone PA, Polston GR, Niemtzow RC, Martin PJ. Integration of acupuncture into the oncology clinic. Palliat Med 2002;16:235–239.

    Article  PubMed  Google Scholar 

  20. Lu W, Posner MR, Wayne P, Rosenthal DS, Haddad RI. Acupuncture for dysphagia after chemoradiation therapy in head and neck cancer: a case series report. Integr Cancer Ther 2010;9:284–290.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Meidell L, Holritz RB. Acupuncture as an optional treatment for hospice patients with xerostomia: an intervention study. Int J Palliat Nurs 2009;15:12–20.

    Article  PubMed  Google Scholar 

  22. Meng Z, Garcia MK, Hu C, Chiang J, Chambers M, Rosenthal DI, et al. Randomized controlled trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma. Cancer 2012;118:3337–3344.

    Article  PubMed  Google Scholar 

  23. Meng Z, Kay GM, Hu C, Chiang J, Chambers M, Rosenthal DI, et al. Sham-controlled, randomised, feasibility trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma. Eur J Cancer 2012;48:1692–1699.

    Article  PubMed  Google Scholar 

  24. Morganstein WM. Acupuncture in the treatment of xerostomia: clinical report. Gen Dent 2005;53:223–227.

    PubMed  Google Scholar 

  25. Rydholm M, Strang P. Acupuncture for patients in hospitalbased home care suffering from xerostomia. J Palliat Care 1999;15:20–23.

    CAS  PubMed  Google Scholar 

  26. Simcock R, Fallowfield L, Monson K, Solis-Trapala I, Parlour L, Langridge C, et al. ARIX: a randomised trial of acupuncture v oral care sessions in patients with chronic xerostomia following treatment of head and neck cancer. Ann Oncol 2013;24:776–783.

    Article  CAS  PubMed  Google Scholar 

  27. Simcock R, Fallowfield L, Jenkins V. Group acupuncture to relieve radiation induced xerostomia: a feasibility study. Acupunct Med 2009;27:109–113.

    Article  PubMed  Google Scholar 

  28. Wang WC, Vachiramon S, Vachiramon A, Vachiramon T. Treatment of xerostomia in prosthetic patients using local acupuncture points on the face. J Contemp Dent Pract 2004;5:133–138.

    PubMed  Google Scholar 

  29. Wu H, Wong K, Wang D. Relief of radiation-induced xerostomia with acupuncture treatment: a case presentation. PM R 2011;3:85–87.

    Article  PubMed  Google Scholar 

  30. Qiao B, Zhang CH, Xing H, Ren XS, Gao XY. A case report about radiation-induced xerostomia. Chin Acupunct (Chin) 2011;31:420.

    Google Scholar 

  31. Zhuang L, Yang Z, Zeng X, Zhua X, Chen Z, Liu L, et al. The preventive and therapeutic effect of acupuncture for radiation-induced xerostomia in patients with head and neck cancer: a systematic review. Integr Cancer Ther 2012;118:3337–3344.

    Google Scholar 

  32. Jedel E. Acupuncture in xerostomia—a systematic review. J Oral Rehabil 2005;32:392–396.

    Article  CAS  PubMed  Google Scholar 

  33. O’Sullivan EM, Higginson IJ. Clinical effectiveness and safety of acupuncture in the treatment of irradiationinduced xerostomia in patients withhead and neck cancer: a systematic review. Acupunct Med 2010;28:191–199.

    Article  PubMed  Google Scholar 

  34. WHO Regional Office for the Western Pacific, ed. A proposed standard international acupuncture nomenclature: report of a WHO scientific group. Manila: World Health Organization; 1991.

  35. WHO Regional Office for the Western Pacific, ed. WHO standard acupuncture point locations in the Western Pacific region. Manila: World Health Organization; 2008.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, West China Medical School, West China Hospital, Sichuan University, Chengdu, 610041, China

    Ling-xin Li  (李凌鑫) & Jing He  (何 竟)

  2. Department of Acupuncture and Moxibustion, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China

    Guang Tian  (田 光)

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  1. Ling-xin Li  (李凌鑫)
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Correspondence to Jing He  (何 竟).

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Li, Lx., Tian, G. & He, J. The standardization of acupuncture treatment for radiation-induced xerostomia: A literature review. Chin. J. Integr. Med. 22, 549–554 (2016). https://doi.org/10.1007/s11655-015-2145-y

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