Ask an answerable question (PICO)：
Chemotherapy is an important treatment for cancer patients. About 30-80% of patients who use neurotoxic chemotherapy drugs suffer from peripheral neuropathy, such as peripheral numbness, burning, and tingling, which affects the patient’s daily activities, quality of life, and causes emotional distress. In severe cases, reducing the drug dosage or even ceasing chemotherapy is necessary; however, the potential solutions that can alleviate these symptoms are limited. Therefore, we hope that through literature review and analysis, we can determine is a better word to use whether acupuncture therapy can alleviate chemotherapy-induced peripheral neuropathy. We can further discuss providing patients with effective symptom treatment, avoiding permanent functional damage, reducing the impact of symptoms on daily activities, improving quality of life and quality of care of cancer patients, and providing clinical references for medical staff.
The Method and Analysis of Literature Review：
Data collection was based on the empirical PICO method, using MeSh term, Entry Terms and synonyms, the keyword included Problem -Chemotherapy, Interventions - Acupuncture, Outcome - Chemotherapy-Induced Peripheral Neuropathy. We used Boolean logic OR and AND to search in the Cochrane Library, UpToDate, PubMed, Embase, CINAHL , Airiti Library, and Taiwan Periodical Literature System databases, and adjusted the search settings appropriately. A total of 713 articles were reviewed is a better word, and duplicated papers, titles, and abstracts not consistent with the research topic were deleted. Two articles that matched the topic were included in the review. One of them was a systematic review, meta-analysis, and the other was a randomized controlled trial articles in 2020.
Critical Appraisal：
Using the CASP checklist and the 2011 Oxford Center's standard of evidence to evaluate the quality of the articles, the two reviewed articles are rated LevelⅠand LevelⅡ.
1. Jin et al. (2020): In this meta-analysis, 19 RCTs with 1174 patients were enrolled. The most common acupoints for CIPN are LI4, LI11, ST36, EX10, and EX-UE 9. Compared with medicine and sham acupuncture, acupuncture significantly increased the total effective rate of CIPN (RR, 1.63; 95% CI, 1.38 to 1.93; p<.00001; I2=0%), restored nerve conduction velocity (95% CI, 2.06 to 2.44; p<.00001), functional assessment of cancer treatment-neurotoxicity (FACT-NTX) score (95% CI, −2.03 to −1.62; p<.00001) and pain improvement (95% CI, -1.71 to -1.58; p<.00001) (LevelⅠ). There are parentheses within parentheses in these sentences that require accurate punctuation, I would advise you look up which punctuation marks to use specifically for medical research.
2. Iravani et al. (2020): For 40 patients with CIPN symptoms over 3 months, the experimental group was treated with acupuncture 3 times a week for 4 weeks. The control group took 300mg vitamin B1 and 300 mg gabapentin every day for 4 weeks. The pain intensity (NRS) and sensory neuropathy grading scale (NCI-CTCAE) were evaluated in the second, fourth, and eighth weeks, and both were significantly decreased over time (both p<.001). At the end of the treatment (4 week later), and after 8 weeks, the experimental group was found to have higher overall satisfaction with the treatment (p<.01 and p<.001, respectively), improving nerve conduction (NCS) (p<.05), and no adverse events related to acupuncture treatment ( LevelⅡ).
Results, Conclusions and Recommendations：
Based on both articles above, acupuncture treatment was found to be safe and improved the recovery of nerve conduction velocity and pain in CIPN patients. There are no ethical issues, can lower the cost of treatment, can reduce the patient’s discomfort arising from peripheral neuropathy, and avoid prolonged hospitalization, which would reduce medical expenses. Acupuncture can be used as an additional choice of treatment for CIPN patients. However, due to the small sample size, the lack of consistent control groups, and the lack of long-term follow up, the results of these studies regarding the effectiveness of acupuncture for CIPN patients should be treated with caution. Future studies should focus on longer follow up and be larger scaled. We hoped that acupuncture treatment can help patients improve the symptoms of peripheral neuropathy caused by chemotherapy more efficiently, providing better cares, improve their quality of life and clinical care satisfaction.
