Electro-acupuncture for quality of life during adjuvant chemotherapy in gastric cancer: a randomized trial
Mené en Chine sur 222 patients atteints d'un cancer de l'estomac, cet essai randomisé évalue l'effet, sur la qualité de vie pendant la chimiothérapie adjuvante, de l'électro-acupuncture
Background: Patients with locally advanced gastric cancer who undergo curative intent gastrectomy experience a decline in health-related quality of life (HRQOL) during adjuvant chemotherapy. The EAGER trial (Electro-Acupuncture in Gastric cancER) sought to evaluate the ability of electro-acupuncture (EA) to preserve HRQOL in these patients.
Methods: In this open-label, multi-center, parallel controlled trial, patients with stage II-III gastric cancer across 11 hospitals in China who were undergoing chemotherapy following gastrectomy were randomly assigned to receive high-frequency EA (HEA), low-frequency EA (LEA), or no EA during the first 3 cycles of chemotherapy. The Functional Assessment of Cancer Therapy-Gastric (FACT-Ga) was reported by patients at baseline and once weekly during the therapy. The primary outcome was the difference among groups in the FACT-Ga Trial Outcome Index (TOI) trajectory during the study duration by the standardized area under the curve (AUC).
Results: Of 222 patients randomized and analyzed, EA was associated with higher HRQOL measured by TOI-AUC [5678 ± 1229 (HEA), 5558 ± 1226 (LEA), and 4735 ± 1233 (control), P < .001]. No difference was seen based on acupuncture dosing (P = .557). Participants in the EA groups also achieved significantly improved disease-free survival (DFS) [HEA vs. Control, HR = 0.47 (0.24-0.93), P = .026; LEA vs. Control, HR = 0.51 (0.28-0.95), P = .030], fewer grade 3-4 adverse events (20.7% vs. 39.0%, P = .004), and decreased peripheral myeloid-derived suppressor cells (P = .038), compared with the control group.
Conclusions: Use of EA resulted in higher HRQOL in gastric cancer patients undergoing adjuvant chemotherapy, irrespective of dosing. EA was also associated with prolonged DFS and lower treatment-associated toxicities, which warrants further confirmative research.
Journal of the National Cancer Institute , résumé, 2025