O uso da Acupuntura para redução de ansiedade e xerostomia radioinduzida em pacientes com câncer de cabeça e pescoço: um estudo randomizado

Abstract

The incidence of head and neck cancer (HNC) has increased in recent years and treatment often leads to sequelae in patients. The main histological type of HCN is squamous cell carcinoma of the head and neck (HNSCC), corresponding to about 90% of the cases. Previous studies have shown that acupuncture during the course of radiotherapy may reduce the development and severity of xerostomia. The aim of the present study was to investigate the effect of the combination of traditional and auricular acupuncture for xerostomia, salivary flow stimulation and anxiety reduction in patients with HNSCC treated with radiotherapy (RT). A two-arm, single-blind trial, which was performed following the established guidelines of clinical trial guidelines using acupuncture (STRICTA), was used as a method. The study had n = 296 patients with HNSCC who were assessed for eligibility, of these, 107 patients were included in the study. A group that did not receive the intervention (n = 55) and another group that received both traditional and atrial acupuncture (n = 52) were involved. The selected local points were Yintang, GV 20; ST 3; ST 4, ST 5, ST 6, ST 7, GB 2, SI 19, and TE 21; the distal points selected were LI 4, LI 11, ST 36, LU 5, LU 9, PC 3, K 3 and K 5. Shen-Men, central nervous system, neurovegetative system, kidneys, spleen, parotid gland, and mouth were also used. The primary endpoint was the reduction of the patient's xerostomia after treatment and the outcome secondary to reduction of anxiety. Evaluations were performed before and after radiotherapy. The study presented the following results: the two groups did not differ in their clinical manifestations that could alter the incidence of xerostomia before RT. However, after RT, the acupuncture protocol used reduced the xerostomia inventory score (self reported) and increased the volume and density of saliva without altering the salivary pH. In addition, acupuncture reduced the Beck Inventory of Anxiety scores after RT. The combination of traditional and auricular acupuncture reduced xerostomia and anxiety and increased the volume of saliva without altering its pH.