Clinical Review Abstract
Trials in Progress Abstract
Abstracts selected for publication but not presentation at the Annual Meeting
Abstracts granted an exception in accordance with ASCO's Conflict of Interest Policy
Antiemetic efficacy of transcutaneous electrical nerve stimulation (TENS) at pericardium 6 acupuncture point (P6) in the treatment of chemotherapy-induced delayed nausea and vomiting (CINV) in stage I to III breast cancer patients during adjuvant/neoadjuvant chemotherapy (Ad/nAd).
Breast Cancer - HER2/ER
2013 ASCO Annual Meeting
J Clin Oncol 31, 2013 (suppl; abstr TPS648)
Author(s): Jean Yared, Melody Hu, Ting Bao, Saranya Chumsri, Emily Catherine Bellavance, Susan Kesmodel, Steven J. Feigenberg, Nancy Tait, Katherine Hanna Tkaczuk; Marlene and Stewart Greenebaum Cancer Center, University of Maryland, Baltimore, MD; University of Maryland, Department of Anesthesiology, Pain Management Division, Baltimore, MD; Department of Medicine, University of Maryland School of Medicine and University of Maryland Greenebaum Cancer Center, Baltimore, MD; University of Maryland, Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD; University of Maryland, Greenebaum Cancer Center, Baltimore, MD
Background: CINV remain major adverse effects of highly emetic chemotherapy for breast cancer patients (BC). Patients (PT) rate nausea & vomiting as the most feared chemotherapy-related symptoms. There is substantial evidence that P6 (located in the region in the middle of the wrist 3 finger breaths from the juncture of the hand & wrist) acupuncture is an effective antiemetic treatment in a variety of PT including the post-anesthesia, obstetrical, and motion sickness PT. We hypothesized that application of TENS at P6 point will reduce:1) the overall incidence of CINV episodes in stage 1-3 BC PT, 2) the severity & duration of CINV, 3) the requirement for rescue antiemetics 4) & that TENS is well tolerated & feasible. Maxima III Transcutaneous Electrical Nerve Stimulation unit is utilized in this study & is self-administered by PT. Patients and Methods: We are conducting a prospective, randomized, double-blinded, controlled trial to determine if self-stimulating P6 may decrease the incidence and severity of delayed CINV in stage 1-3 BC treated with the initial dose of highly emetic Ad/nAd (AC, AC-T, TAC, TC, TCH) and reduce PT' need for rescue oral antiemetic medications. PT will be randomized in a 1:1 ratio to the active treatment group (TENS self-stimulation at P6) & the control group (TENS self-stimulation at a point on the lateral side of the elbow that does not conform to any known acupuncture points). The assignments are blinded to the PT & the investigators. Subjects self-administer TENS at home q4 hours for 20 minutes during days 2-5 postchemotherapy. The use of conventional antiemetic therapy (corticosteroids, setrons, aprepitant, phenergan & prochlorperazine) is similar for both treatment groups. The severity of nausea symptoms, episodes of emesis, use of rescue antiemetics, and compliance are recorded daily by the PT in diaries. A brief questionnaire is also administered to evaluate PT tolerability of TENS & their ability to comply with the treatment regimen. Twenty six out of 70 planned PT have been enrolled. Recruitment is ongoing.
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