Haest, K., Kumar, A., Van Calster, B., Leunen, K., Smeets, A., Amant, F., . . . Neven, P. (2012). Stellate ganglion block for the management of hot flashes and sleep disturbances in breast cancer survivors: an uncontrolled experimental study with 24 weeks of follow-up. Annals of Oncology, 23, 1449–1454.doi: 10.1093/annonc/mdr478
Researchers studied the long-term efficacy of stellate ganglion block (SGB) treatment in reducing hot flashes (HF) and improving sleep disturbances in breast cancer survivors.
Female breast cancer survivors who were experiencing HF and sleep disturbances were enrolled to undergo SGB treatment. A pilot study was conducted on nine patients before the main study enrolled 25 patients for the SGB treatment. In the pilot study, patient assessments occurred at baseline (one week before SGB) and four weeks after treatment. In the main study, patients were assessed at baseline and at weeks 1, 4, 12, and 24 after treatment.
This was a prospective, single-arm, nonrandomized trial.
The Climacteric Symptom Form, HF diary, and Pittsburgh Sleep Quality Index (PSQI) were used to assess the efficacy of SGB on HF and sleep quality.
This study was divided into two parts: a pilot study of nine patients and the main study of 25 patients. All patients completed the treatment intervention (SGB) and the assessment to week 24.
SGB appears to be effective in reducing the number of HF and improving sleep quality in women with early stage breast cancer who are experiencing HF and are resistant to other therapies. The HF gradually returned over time, whereas the improvement in the sleep quality was maintained over 24 weeks. The study demonstrated excellent patient compliance and noted very few side effects other than treatment-induced Horner’s syndrome (ptosis, miosis, anhidrosis, and enophthalmos) that lasted less than six hours.
The treatment was reported to be safe and very well tolerated, and the side effects were minimal. Further investigation is warranted to identify feasibility in community practices as well as further identification of the appropriate patient population for this intervention.