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NCT Number: NCT06769061

The Use of Acupuncture to Reduce Chemotherapy Induced Peripheral Neuropathy in Gynaecological Cancer Patients

Objectives:

To explore the feasibility and effectiveness of acupuncture on reducing Chemotherapy Induced Peripheral Neuropathy (CIPN) in gynaecological cancer patients who have received carboplatin and paclitaxel chemotherapy combination. Results of this pilot trial will provide preliminary information for a potential a larger scale multicentre study.

Hypothesis:

Acupuncture can significantly reduce CIPN in gynaecological cancer patients treated with chemotherapy

Design and subjects:

This is a pilot, prospective randomised controlled trial. This is an exploratory trial to evaluate the feasibility and effectiveness of acupuncture in reducing CIPN in gynaecological cancer patients. Eligible patients will be 1:1:1 randomised to three groups: electroacupuncture group, sham acupuncture group and waiting-list (usual care) control group. For electroacupuncture and sham acupuncture groups, the assessors and the patients will be blinded to the treatment given.

1. Electroacupuncture group - patients will receive 6 weeks of electroacupuncture, 2 sessions per week, by a qualified Traditional Chinese Medicine practitioner from the School of Chinese Medicine. 2. Sham acupuncture group - patients will receive 6 weeks of sham acupuncture similar to the above. 3. Waiting-list (usual care) control group - patients will not receive any treatment.

Main outcomes:

Acupuncture effects will be assessed at baseline and 3, 6,12 weeks post intervention by:

1. Patient reported outcome measures: FACT/GOG-Ntx questionnaire for assessing CIPN symptoms and EORTC-QLQ-C30 and CIPN20 questionnaires for assessing quality of life symptom 2. Clinician reported outcome measures: NCI-CTCAE grading for CIPN by clinicians and Semmes-Weinstein monofilament test as an objective measurement of CIPN.

Data analysis:

Intention to treat analysis will be carried out. Baseline demographics will be compared between the 3 groups. Change from baseline total score will be calculated and analysed using 2-sample t-test. 95% CI will be reported for treatment differences. Score for different subcategories will be analysed in a similar manner. Data collected at week 6 will be used for outcome analysis. P<0.05 will be considered as statistically significant. Acupuncture efficacy, effectiveness and placebo effect will be indicated by comparison of acupuncture vs. sham acupuncture, acupuncture vs. waiting-list, and sham acupuncture vs. waiting-list, respectively.

Expected results: Patients in the acupuncture arm will have reduced numbness and peripheral neuropathy and improved quality of life without any adverse event.

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Key information

Conditions

Gynaecological, Urological or Rectal Cancer Acupuncture Chemotherapy-induced Peripheral Neuropathy Colorectal Neoplasms Digestive System Diseases Digestive System Neoplasms Gastrointestinal Diseases Gastrointestinal Neoplasms Intestinal Diseases Intestinal Neoplasms Neoplasms Neoplasms by Site Rectal Diseases Rectal Neoplasms

Age range

18 year and older

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Department of Obstetrics and Gynaecology

Hong Kong

Location status: Recruiting

Location contact

Karen Kar Loen CHAN, MBBChir (Cantab); MD (HK)

CONTACT

[email protected]

852-22554265

Karen Kar Loen CHAN, MBBChir (Cantab); MD (HK)

PRINCIPAL_INVESTIGATOR

Tina WEI, PhD

CONTACT

[email protected]

852-22554265

About this study

Subjects will be recruited by research assistant at the gynaecological oncology clinics at Queen Mary Hospital. All potential subjects will be required to fill in a screening questionnaire to assess the degree of neuropathy. Screening blood test (Complete blood picture) will be taken within 1 month of starting acupuncture. Eligible subjects will be enrolled into the study according to the inclusion and exclusion criteria. Any type of acupuncture or message in daily Traditional Chinese Medicine clinic will be prohibited during the trial once the subject is enrolled.

Subjects will be allocated to the 3 groups through computer generated randomization: acupuncture, sham acupuncture or the waiting-list (usual care) control group on a 1:1:1 ratio. Allocations will be kept within sealed opaque envelopes. Once a patient has been enrolled, an envelope is opened and the patient is then offered the allocated treatment regimen. Both the subjects (acupuncture and sham acupuncture group) and the gynaecological clinical research team responsible for the clinical care and neuropathy assessments will be blinded to the results.

Patients who are randomised to sham acupuncture or waiting-list control group will be offered the option of receiving 12 acupuncture treatments when they finish all study procedures.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 18 or above
  • Diagnosis of uterine (endometrial) cancer, ovarian cancer and cervical cancer
  • ECOG=0-2
  • Life expectancy of > 6 months
  • Completed at least 6 cycles of carboplatin or cisplatin chemotherapy together with paclitaxel at least 3 months before joining the study
  • Able to read and understand the questionnaires
  • PNQ score of C or above

Exclusion criteria

  • Bleeding tendency
  • Abnormal clotting profile
  • Platelet lower than 50
  • Received acupuncture in the past
  • Currently receiving chemotherapy treatment
  • Known neurological disorders or pre-existing neuropathy unrelated to chemotherapy
  • Routinely take aspirin or any anticoagulant drugs
  • Having active skin infection
  • With pacemaker

Treatment and study plan

Acupuncture

Procedure

Patients will receive 6 weeks of electroacupuncture, 2 sessions per week, 30 min per session Stainless steel, single-use, sterile, and disposable needles will be used. We will use the bilateral acupoints LI4 (He-Gu), TE5 (Wai-Guan), LI11 (Qu-Chi), and LU5 (Chi-Ze) for upper limbs. For lower limb numbness, we will use the bilateral acupoints of LV3 (Tai-Chong), ST41 (Jie-Xi), SP6 (San-Yin-Jiao), and GB34 (Yang-Ling-Quan) for the numbness of back of feet, or the bilateral acupoints of KI1 (Yong-Quan), KI3 (Tai-Xi), SP6 (San-Yin-Jiao), and GB34 (Yang-Ling-Quan). After skin disinfection, sterile adhesive pads will be placed on bilateral LI4 (Hegu), TE5 (Waiguan), LI11 (Quchi), and LU5 (Chize). Following each needle insertion, acupuncturists will perform equal manipulations of twirling, lifting, and thrusting on the needle by acupuncturists to achieve the de qi sensation. These 4 acupoints (He-Gu, Qu-Chi, San-Yin-Jiao, Yang-Ling-Quan) will be electrically stimulated for 30 min.

Sham acupuncture

Device

Patients will receive 6 weeks of sham acupuncture, 2 sessions per week, 30 min per session. The Streitberger sham acupuncture needle designed specifically for sham acupuncture trials will be used. Patients will feel the needle on the skin, but the needle actually will not puncture the skin. These 4 acupoints (He-Gu, Qu-Chi, San-Yin-Jiao, Yang-Ling-Quan) will be connected to the electrical stimulation device KWD-808I MULTI-PURPOSE Health device (Great Wall Company), but not stimulated. The needle will remain for 30 minutes. without stimulating the acupoints. The sham acupuncture will be used within the trocar. The trocar will be fixed by a base on the skin with sticker. The trocar-base-sticker will be used for both acupuncture group and sham acupuncture control group, so they are exactly the same in appearance. Patients cannot see if there is acupuncture or sham acupuncture within the trocar.

Primary outcomes

  1. Chemotherapy Induced Peripheral Neuropathy associated quality of life measured by Functional Assessment of Cancer Therapy / Gynecologic Oncology Group - Neurotoxicity subscale (FACT/GOG-NTX) total score

    Time frame: From enrollment to 6 weeks after end of treatment including: baseline at enrollment, after 3 weeks of treatment/enrollment, after 6 weeks of treatment (end of treatment)/ enrollment, and 6 weeks after end of treatment /12 weeks after enrollment

    This questionnaire provides a targeted assessment of peripheral neuropathy symptoms. It consists of a total of 38 items on physical, social, emotional and functioning well-being with 11 questions focusing on neurotoxicity. This instrument is validated and has been used in Phase 3 clinical trials. The higher the score, the better the quality of life.

Secondary outcomes

  1. The changes in quality of life assessed by European Organisation For Research And Treatment Of Cancer-Quality of Life-C30 (EORTC-QLQ-C30) questionnaires

    Time frame: From enrollment to 6 weeks after end of treatment including: baseline at enrollment, after 3 weeks of treatment/enrollment, after 6 weeks of treatment (end of treatment)/ enrollment, and 6 weeks after end of treatment /12 weeks after enrollment

    Quality of life will be assessed by patient reported EORTC-QLQ-C30 questionnaires): C30 is a well validated instrument to assess quality of life in cancer patients. It consists of 30 items encompassing physical, emotional, social and functional aspects. Higher scores indicate better quality of life

  2. The changes in quality of life assessed by European Organisation For Research And Treatment Of Cancer-Quality of Life-Chemotherapy Induced Peripheral Neuropathy 20 (EORTC-QLQ-CIPN20) questionnaires

    Time frame: From enrollment to 6 weeks after end of treatment including: baseline at enrollment, after 3 weeks of treatment/enrollment, after 6 weeks of treatment (end of treatment)/ enrollment, and 6 weeks after end of treatment /12 weeks after enrollment

    Quality of life will be assessed by patient reported EORTC-QLQ-CIPN20 questionnaires: CIPN20 is a 20 items additional module to EORTC-QLQ-C30 focusing on Chemotherapy Induced Peripheral Neuropathy symptoms. Higher scores indicate better quality of life

  3. assess the changes in light touch sensation by Semmes-Weinstein filaments test

    Time frame: From enrollment to 6 weeks after end of treatment including: baseline at enrollment, after 3 weeks of treatment/enrollment, after 6 weeks of treatment (end of treatment)/ enrollment, and 6 weeks after end of treatment /12 weeks after enrollment

    For assessment the light touch sensation, the research assistant will perform Semmes-Weinstein filaments (SWM) test at the same time points as the patient's questionnaires (Baseline, Week 3, 6, 12). Each monofilament will be used for three consecutive times on the same point, and the participants are asked to provide information about their sense of touch with their eyes closed. The testing session starts using the thinnest monofilament, moving to a thicker one if the participant does not feel a monofilament.

  4. assess the safety by National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) grading

    Time frame: From enrollment to 6 weeks after end of treatment including: baseline at enrollment, after 3 weeks of treatment/enrollment, after 6 weeks of treatment (end of treatment)/ enrollment, and 6 weeks after end of treatment /12 weeks after enrollment

    Any adverse effects and their severity during treatment procedures including dizziness, nausea, vomiting, pain, discomfort, sweating, palpitations, bleeding and bruising will be assessed by CTCAE. The intervention will be discontinued if patients suffer from any serious adverse events (AEs). AE will be managed according to standard of care procedures.

  5. assess the chemotherapy induced peripheral pain in numeric rating scale

    Time frame: From enrollment to 6 weeks after end of treatment including: baseline at enrollment, after 3 weeks of treatment/enrollment, after 6 weeks of treatment (end of treatment)/ enrollment, and 6 weeks after end of treatment /12 weeks after enrollment

    Numeric rating scale represents a key element for measuring pain intensity and symptomatology. It ranges from 0 to 10. 0 means no pain and 10 means maximum pain.

  6. Explore the acupuncture expectancy by Acupuncture expectancy scale (for acupuncture and sham acupuncture group)

    Time frame: At baseline and week 3 (after receiving treatment for 3 weeks)

    In order to control the bias from placebo effect of acupuncture, acupuncture expectance scale will be used to measure the patients' expectations of positive outcomes from the treatment. It is a validated measurement with four items, with score ranging from 4 to 20

  7. Explore the acupuncture credibility by Acupuncture credibility questionnaire (for acupuncture and sham acupuncture group)

    Time frame: At week 3 (after receiving treatment for 3 weeks)

    Acupuncture credibility questionnaire is a questionnaire to control the bias from different patients' credibility of acupuncture practitioners. It is a validated assessment including 4 questions with score ranging from 0 to 6. 0 means minimum and 6 means maximum agreement of the item

  8. Changes in inflammatory biomarkers

    Time frame: From enrollment to end of treatment including: baseline at enrollment, after 6 weeks of treatment (end of treatment)/ enrollment

    Changes in inflammatory biomarkers after acupuncture will be explored. The BD cytometric Bead Array system (CBA) will be used to quantify the level of inflammation panel (IL10, IL12-p70, IL1β, IL6), Th1/Th2 panel (IL2, IL4, IL5, TNF, IFNγ), B cell activation panel (CD79b, BLNK, Btk, Syk, PLCγ), T cell activation panel (TCRz, SLP-76, ZAP70, Pyk2, Itk), and the Complements panel (C4a, C3a, C5a). The plasma level of CRP will be determined by ELISA assay. Fecal samples will be sent for fecal sequencing and profiling to explore the potential mechanisms of acupuncture effects.

Study contacts

Contact information is provided by the study sponsor or research team.

Karen Kar Loen CHAN, MBBChir (Cantab); MD (HK)

CONTACT

[email protected]

852-2255 4265

Tina Na WEI, PhD

CONTACT

[email protected]

852-22554265

Sponsors and collaborators

Lead sponsor

Karen Kar Loen CHAN

Other

Registry information

Official study title

The Use of Acupuncture to Reduce Chemotherapy Induced Peripheral Neuropathy (CIPN) in Gynaecological Cancer Patients - A Pilot Randomised Controlled Trial

Acronym: AcuCIN

Important dates

Study start
2025
Primary completion
2027
Study completion
2027
First posted
Jan 10, 2025
Registry last updated
Feb 25, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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