Gottschling, S., Reindl, T.K., Meyer, S., Berrang, J., Henze, G., Graeber, S., … Graf, N. (2008). Acupuncture to alleviate chemotherapy-induced nausea and vomiting in pediatric oncology—A randomized multicenter crossover pilot trial. Klinische Padiatrie, 220, 365–370. 

To evaluate the efficacy and acceptance of acupuncture as an additive antiemetic treatment during highly emetogenic chemotherapy (HEC) in pediatric patients with cancer

Patients receiving chemotherapy were randomized to receive antiemetic medication plus acupuncture or antiemetic medication alone.

• Group 1 participants received acupuncture before chemotherapy, were offered acupuncture daily during chemotherapy, and received no acupuncture in their subsequent chemotherapy.
• Group 2 received treatments in the opposite order.

Acupuncture points were based on the acupuncturists’ decision, until the patient reported a “de Qi” sensation.

Antiemetic rescue medication, number of retching and vomiting episodes, and a short essay of the acupuncture experience were recorded.

• The sample consisted of 23 participants.
• The patients' ages ranged from 6-18 years with a mean of 13.6 years and standard deviation of 2.9 years.
• The sample was 56.5% female and 43.5% male.
• Diagnoses were Ewing sarcoma, rhabdomyosarcoma, osteosarcoma, undifferentiated sarcoma, and synovial sarcoma.
• Patients who had full control of chemotherapy-induced nausea and vomiting (CINV) without need for antiemetic rescue medication during the first chemotherapy course were excluded from the study.

This study was conducted in multiple inpatient settings in five German cancer centers.

This was a prospective, randomized, crossover clinical trial pilot study.

An open-form essay was used to document the subjective experience of acupuncture.

In evaluating chemotherapy courses, overall, no significant differences were found in retching or vomiting episodes. In evaluating differences between group 1 and group 2, no significant effect was found with dexamethasone (p = 0.145); however, the acupuncture group was associated with lower phenothiazine medication use (p = 0.001) and less retching and vomiting episodes (p = 0.01).

Acupuncture with baseline antiemetic medication was associated with less phenothiazine use and less retching and vomiting among children receiving HEC.

• The sample was small.
• The number of times that the children received acupuncture depended on individual patient requests and was not recorded.
• Acupuncture sessions did not follow a standard procedure of needle placement, and differences among acupuncturists may provide differing results.
• The methods for recording retching and vomiting episodes were not documented.
• Although one of the study aims was to evaluate acceptance of acupuncture, the authors did not specify how this was measured.
• The title suggests that the study evaluated nausea, but this was not discussed.

Acupuncture may provide some relief of retching or vomiting episodes associated with HEC, but the intervention should be used in combination with standard antiemetic treatment.