Choo, S.P., Kong, K.H., Lim, W.T., Gao, F., Chua, K., & Leong, S.S. (2006). Electroacupuncture for refractory acute emesis caused by chemotherapy. The Journal of Alternative and Complementary Medicine, 12, 963-969.

To evaluate the use of electroacupuncture in preventing anthracycline-based chemotherapy-related nausea and vomiting (CINV) refractory to combination 5-HT₃-antagonist and dexamethasone

Patients received electroacupuncture in addition to standard antiemetic prophylaxis. Acupuncture was started 10 minutes prior to start of chemotherapy infusion and then continued for an additional 20 minutes. The P6 acupuncture point was used, a second needle was inserted at a different point, and electrical stimulation was delivered. 

• The study consisted of 27 patients with breast cancer.
• All patients were receiving their second cycles of doxorubicin and cyclophosphamide; cyclophosphamide, doxorubicin, and prednisone; or doxorubicin only.
• Patients were defined as having refractory emesis (defined as vomiting three or more times, 24-48 hours after cycle one).
• Patients received standard antemetic prophylaxis.

This was a prospective trial.

• Patients completed a questionnaire assessing their attitudes toward acupuncture. 
• Patients recorded frequency of vomiting in diaries.
• A trained doctor interviewed patients via telephone 24-48 hours after chemotherapy to grade nausea and vomiting using the National Cancer Institute Common Toxicity Criteria (NCI-CTC).

• Ten patients (37%) reported no vomiting after the second cycle of chemotherapy with the addition of electroacupuncture.
• The majority of patients (96%) reported significantly less nausea and vomiting, but one patient experienced increased vomiting after electroacupuncture.
• Overall, mean emetic episodes decreased from 7 to 3 after the intervention (p < 0.0001).
• NCI grade of vomiting decreased significantly (p = 0.0120).
• The number of patients reporting grade 3-4 vomiting dropped from 14 prior to the electroacupuncture to 5 after the electroacupuncture.
• NCI grade of nausea improved as well after the intervention (p < 0.0001).
• Most patients (93%) reported that they thought that electroacupuncture was an acceptable procedure and helpful in reducing emesis.

• All patients participated in the intervention group; no control group was provided.
• Two subjects complained of severe headaches after the electroacupuncture, lasting for several days; otherwise it was well-tolerated.
• The intervention was delivered by trained acupuncturists.