Melchart, D., Ihbe-Heffinger, A., Leps, B., von Schilling, C., & Linde, K. (2006). Acupuncture and acupressure for the prevention of chemotherapy-induced nausea: A randomised cross-over pilot study. Supportive Care in Cancer, 14, 878-882.

To study the effectiveness of acupuncture and acupressure in reducing chemotherapy-induced nausea

Patients were treated for one cycle of chemotherapy with acupuncture and acupressure at point P6 and for one cycle at a close sham point. Participants were randomized to acupuncture at P6 or at a close nonacupuncture point, and it was delivered by one of two physicians with training and experience in acupuncture. Participants wore acupressure bands for 72 hours at the same points on both arms and could wear them for an additional four days if needed. The bands were covered with a mull bandage to blind the staff. Participants completed diaries for seven days, documenting intensity (on a 0-6 rating scale), frequency, and duration of nausea and vomiting; additional antiemetics taken; and, on day 7, rate the effectiveness of side effects or impairment by acupuncture or acupressure. Patients completed the Morrow Assessment of Nausea and Emesis (MANE). Oncology staff checked that the diaries were completed accurately, standard antiemetics regimens were followed, and if any adverse reactions related to acupuncture occurred.

• The study consisted of 28 patients receiving moderately emetogenic chemotherapy (MEC) or highly emetogenic chemotherapy (HEC).
• Patients were eligible for the study if they
  • Were 18-75 years old.
  • Were scheduled to receive MEC or HEC and standard antiemesis additional medication for rescue predefined for two cycles of chemotherapy.
  • Had a Karnofsky index of 50%.
• Patients were excluded from the study if they had
  • Received chemotherapy within the last three months.
  • Experienced anticipatory nausea and vomiting, cerebral metastasis, chronic ileus or subileus, or lymphedema in arms.
  • Prior knowledge of acupressure points.

The study was conducted by the hematology and gastroenterology departments of a large university hospital in Germany.

This was a randomized, crossover pilot study.

• The MANE, shortened version, was used to measure nausea.
• Patients recorded the Intensity, frequency, and duration of nausea in patient diaries.

• No difference was found between combined acupuncture and acupressure at the P6 point and at the sham point.
• The study was stopped early because of recruitment problems and low incidence of nausea and vomiting in the sham group.
• Half of the participants reported an irradiating feeling, which is a sign of effective acupuncture.

• The sample size was small.
• Incidence of nausea was low in the sham group.
• No acupuncture control group was included.
• No control was included for type of cancer or chemotherapy regimen.
• The sham point may have been too close to P6 or the needle was too deep.