When used in conjunction with radiotherapy for cancer of the head and neck, acupuncture has shown for the first time, reducing the debilitating side effect of xerostomia, according to new research from the University of Texas MD Anderson Cancer Center and Shanghai’s Fudan University Cancer Center.

The study, published in the journal Cancer, reported results from the first randomized, controlled trials of acupuncture to prevent xerostomia.

Xerostomia or severe dry mouth, characterized by reduced salivary flow, which often affects patients receiving radiotherapy for cancer of the head and neck. Most current treatments are palliative and offer limited benefit, according to Lorenzo Cohen, Ph.D., professor in the departments of General Oncology, MD Anderson and behavioral sciences and director of the program “Integrative Medicine.

Worsen the quality of life for patients because it causes problems in eating, talking and sleeping, and increased risk of oral infections.

“There are a number of small studies of the benefits of acupuncture for xerostomia develops, but none have previously examined whether it could prevent xerostomia,” says Cohen, who also is principal investigator of the study. “We found, including acupuncture, along with radiation therapy reduces the incidence and severity of this side effect.”

Cohen and his colleagues examined 86 patients with nasopharyngeal carcinoma treated at Shanghai’s Fudan University Cancer Center. Forty patients were randomized to acupuncture and 46 standard care. The arm was treated with acupuncture treatment three times a week for the seven-week radiation therapy. Patients were assessed before chemotherapy weekly during radiotherapy and then again one and six months later.

Results are based on data obtained from two self report questionnaires and measuring the actual flow of saliva. Patients completed xerostomia questionnaire (XQ), eight-point test that assesses symptoms, in accordance with the condition. XQ results below 30 years were consistent with mild or no symptoms of xerostomia.

The second measure, the MD Anderson Symptom Inventory head and neck (MDASI-HN), ranked the severity of symptoms associated with cancer than dry mouth, and interference with quality of life. The team also measured saliva flow by means of standardized methods for collecting sialometry.

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“It is quite remarkable is that we began to see group differences by three weeks radiotherapy for the development of xerostomia associated with cancer symptoms affecting quality of life and rates of saliva flow – an important objective measure,” said Zhiqiang Meng, MD, principal investigator of the study and vice-chairman of the Department of Integrative Oncology, Fudan University Shanghai Cancer Center.

The largest differences in XQ group results were observed at the end of radiotherapy, but differences remained over time. Within one month after radiotherapy, compared 54.3% of the acupuncture group XQ scores higher than 30, with the control group to 86.1%. Within six months after radiotherapy, the numbers fell to 24.1% in the acupuncture group and 63.6% of the control group still reported symptoms of xerostomia. Salivary flow rates were also higher in the acupuncture group, begins three weeks radiotherapy and continued for one and six month follow up.

Acupuncture also helped cancer-related symptoms other than xerostomia, as measured by MDASI-HN questionnaire differences, which appeared in three weeks and continuing every six months.

“Medical consequences are quite profound, in terms of quality of life, because while chronic dry mouth may sound – benign, a significant impact on sleep, eat and talk,” says Cohen. “Without saliva, there may be an increase in the growth of microbes, possible bone infections and nutritional deficiencies irreversible.”

Further studies are needed to determine the mechanisms of the benefits of acupuncture, but the study did not examine this question, Cohen said it could have an impact on local blood flow, especially to the parotid gland.

Further studies are planned, including a major study conducted at MD Anderson in collaboration with Shanghai Fudan University Cancer Center. Both centers will be included 150 patients undergoing radiotherapy for cancer of the head and neck: 50 will receive acupuncture, placebo acupuncture, 50 and 50 will be involved in the control group. Researchers will also examine the components of saliva and a number of other measures to better define the mechanisms of acupuncture.