Rithirangsriroj, K., Manchana, T., & Akkayagorn, L. (2015). Efficacy of acupuncture in prevention of delayed chemotherapy induced nausea and vomiting in gynecologic cancer patients. Gynecologic Oncology, 136, 82–86.

To compare the efficacy of ondansetron versus acupuncture in the prevention of delayed chemotherapy-induced nausea and vomiting (CINV)

Patients were randomized to receive acupuncture (applied to wrists) or ondansetron (8 mg IV for 30 minutes) before chemotherapy. Acupuncture also was applied the day after chemotherapy. All patients received dexamethasone at 5 mg orally twice per day for three days following chemotherapy. Ondansetron at 4 mg was administered orally every 12 hours for vomiting. During subsequent chemotherapy infusions, patients received the other intervention in a crossover design. Data on CINV were collected for five days after the administration of chemotherapy, and quality-of-life data were collected on the seventh day following chemotherapy.

• N = 70
• AVERAGE AGE = 51.6 years
• FEMALES: 100%
• KEY DISEASE CHARACTERISTICS: Patients with gynecologic cancers receiving similar chemotherapy regimens of carboplatin and paclitaxel and similar premedications before chemotherapy
• OTHER KEY SAMPLE CHARACTERISTICS: Exclusion criteria included vomiting or use of antiemetics within 24 hours, abdominal or pelvic radiation within 48 hours prior to or during the study, evidence of brain metastasis, bowel obstructions, or other serious concurrent conditions.

• SITE: Not stated  
• SETTING TYPE: Not specified    
• LOCATION: Bangkok, Thailand

• PHASE OF CARE: Active antitumor treatment
• APPLICATIONS: Elder care

Randomized, crossover study

• Patients self-reported the severity of nausea, incidents of emesis, and required doses of oral ondansetron.  
• Functional Assessment of Cancer Therapy–General (FACT-G)

Patients in the intervention group had a higher rate of complete response for delayed CINV (p = 0.02), less delayed nausea (p = 0.004), lower nausea scores (p < 0.001), and fewer doses of additional ondansetron (p = 0.002). Fewer patients reported adverse side effects when receiving acupuncture. Forty patients reported that they preferred acupuncture to ondansetron.

Acupuncture was effective in the prevention of delayed CINV and nausea. Patients receiving acupuncture also required fewer doses of ondansetron during the delayed phase of CINV.

• Small sample (< 100)
• Risk of bias (no control group)
• Findings not generalizable

Although additional research with a larger and more diverse sample is needed, the use of acupuncture to manage CINV could represent an effective nursing intervention for patients receiving platinum-based chemotherapy.