Acupuncture Ameliorates Chronic Xerostomia After Radiation for Head and Neck Cancer
The randomized ARIX (Acupuncture in the treatment of Radiation-Induced Xerostomia) trial found that “a course of group acupuncture was useful in relieving symptoms of dry mouth, and provided greater benefit than oral care alone,” noted lead author Dr. Richard Simcock of Brighton and Sussex University Hospitals Trust, Sussex Cancer Centre, Brighton, United Kingdom.
The study recruited 145 patients with chronic radiation-induced xerostomia >18 months after treatment from seven UK cancer centers. Patients were randomly assigned to group acupuncture sessions for 20 minutes every week for 8 weeks, or two oral care educational sessions for 1 hour, 1 month apart. After 4 weeks off treatment, patients were crossed over to the other arm. Each participant completed patient-reported outcome measures at baseline and at weeks 5, 9, 13, 17, and 21. Primary outcome was improvement in dry mouth; symptoms of xerostomia were measured using Schirmer strips.
Compared with oral care, acupuncture significantly reduced patient reports of severe dry mouth (OR 2.01; P=0.031) sticky saliva (OR 1.67; P=0.048), needing to sip fluids to swallow food (OR 2.08; P=0.011), and in waking up at night to drink (OR 1.71; P=0.013).
“Time had an important effect on key symptoms, with patients receiving acupuncture showing a quick response, which was sustained over several weeks,” Dr. Simcock said.
“Acupuncture benefits may be subject to attrition over time, and we do not know how enduring the effects were beyond 3 months,” he noted. “However, the trial appears to establish the effectiveness of the technique, and group sessions offer a pragmatic and affordable system of delivering the intervention. Future studies may be warranted to refine the technique further, establish the duration of benefit and length of treatment, or booster sessions needed to improve and maintain efficacy.”