L Lee Dupuis1,2, Kara M Kelly3,4, Jeffrey P Krischer5,6, Anne-Marie Langevin7, Roy N Tamura5, Ping Xu5, Lu Chen8, E Anders Kolb9, Nicole J Ullrich10,11, Olle Jane Z Sahler12, Eleanor Hendershot13,14, Ann Stratton15, Lillian Sung16,17, Thomas W McLean18. 1. Department of Pharmacy and Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada. 2. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada. 3. Department of Pediatrics, Roswell Park Cancer Institute, Buffalo, New York. 4. Division of Pediatric Hematology/Oncology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York. 5. Health Informatics Institute, University of South Florida, Tampa, Florida. 6. College of Medicine, University of South Florida, Tampa, Florida. 7. Division of Pediatric Hematology/Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas. 8. Department of Information Sciences, City of Hope, Duarte, California. 9. Division of Pediatric Hematology/Oncology, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware. 10. Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts. 11. Harvard Medical School, Boston, Massachusetts. 12. Pediatric Hematology/Oncology, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, New York. 13. Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada. 14. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada. 15. Department of Cancer and Blood Disorders, Akron Children's Hospital, Akron, Ohio. 16. Department of Pediatrics, Division of Hematology/Oncology and Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada. 17. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 18. Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Abstract
BACKGROUND: Chemotherapy-induced nausea and vomiting remain common, distressing side effects of chemotherapy. It has been reported that acupressure prevents chemotherapy-induced nausea in adults, but it has not been well studied in children. METHODS: In this multicenter, prospective, randomized, single-blind, sham-controlled trial, the authors compared acute-phase nausea severity in patients ages 4 to 18 years who were receiving highly emetic chemotherapy using standard antiemetic agents combined with acupressure wrist bands, the most common type ofacupressure, versus sham bands. Patients wore acupressure or sham bands continuously on each day of chemotherapy and for up to 7 days afterward. Chemotherapy-induced nausea severity in the delayed phase and chemotherapy-induced vomiting control in the acute and delayed phases also were compared. RESULTS: Of the 187 patients randomized, 165 contributed nausea severity assessments during the acute phase. Acupressure bands did not reduce the severity of chemotherapy-induced nausea in the acute phase (odds ratio [OR], 1.33; 95% confidence limits, 0.89-2.00, in which an OR <1.00 favored acupressure) or in the delayed phase (OR, 1.23; 95% CL, 0.75-2.01). Furthermore, acupressure bands did not improve daily vomiting control during the acute phase (OR, 1.57; 95% CL, 0.95-2.59) or the delayed phase (OR, 0.84; 95% CL, 0.45-1.58). No serious adverse events were reported. CONCLUSIONS:Acupressure bands were safe but did not improve chemotherapy-induced nausea or vomiting in pediatric patients who were receiving highly emetic chemotherapy. Cancer 2018;124:1188-96.
RCT Entities:
BACKGROUND: Chemotherapy-induced nausea and vomiting remain common, distressing side effects of chemotherapy. It has been reported that acupressure prevents chemotherapy-induced nausea in adults, but it has not been well studied in children. METHODS: In this multicenter, prospective, randomized, single-blind, sham-controlled trial, the authors compared acute-phase nausea severity in patients ages 4 to 18 years who were receiving highly emetic chemotherapy using standard antiemetic agents combined with acupressure wrist bands, the most common type of acupressure, versus sham bands. Patients wore acupressure or sham bands continuously on each day of chemotherapy and for up to 7 days afterward. Chemotherapy-induced nausea severity in the delayed phase and chemotherapy-induced vomiting control in the acute and delayed phases also were compared. RESULTS: Of the 187 patients randomized, 165 contributed nausea severity assessments during the acute phase. Acupressure bands did not reduce the severity of chemotherapy-induced nausea in the acute phase (odds ratio [OR], 1.33; 95% confidence limits, 0.89-2.00, in which an OR <1.00 favored acupressure) or in the delayed phase (OR, 1.23; 95% CL, 0.75-2.01). Furthermore, acupressure bands did not improve daily vomiting control during the acute phase (OR, 1.57; 95% CL, 0.95-2.59) or the delayed phase (OR, 0.84; 95% CL, 0.45-1.58). No serious adverse events were reported. CONCLUSIONS: Acupressure bands were safe but did not improve chemotherapy-induced nausea or vomiting in pediatric patients who were receiving highly emetic chemotherapy. Cancer 2018;124:1188-96.
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