Avaliação do efeito da Acumputura combinado com antieméticos na profilaxia de náusea e vômitos induzidos por quimioterapia no câncer de mama

Abstract

Introduction: Breast cancer is one of the leading causes of morbidity in Brazil, with 73,000 new cases estimated for the 2023-2025 period. Treatment includes chemotherapy, surgery, and radiotherapy, with combined chemotherapy being one of the most effective approaches. However, adverse effects such as chemotherapyinduced nausea and vomiting (CINV) are common and affect up to 80% of patients, significantly impairing quality of life. These symptoms can be classified as acute or delayed, depending on the onset time, and their severity varies according to the emetogenic potential of the cnemotherapeutic agents and individual patient factors. Acupuncture, a practice rooted in traditional Chinese medicine, has been evaluated as a complementary option to reduce CINV, providing fisiologic balance and symptom relief with few adverse effects. Objective: This pilot study aims to assess whether the combination of antiemetic pharmacological prophylaxis and Acupuncture improves the quality of life of breast cancer patients undergoing chemotherapy at the Hospital de Base in São José do Rio Preto, SP. Material and Method: Thirty breast cancer patients were randomized into two groups for an intention-to-treat analysis. The control group received only pharmacological prophylaxis during the first two chemotherapy sessions, and after a cross-over, they were given Acupuncture combined with medication in the last two sessions. The intervention group received a combination of acupuncture and medication during the first two sessions, followed by only medication during the last two. Chemotherapy involves intravenous cycles of cyclophosphamide and doxorubicin. Acupuncture was performed before the chemotherapy sessions at points PC6, LI4, ST36, LR3, and CV12. Treatment efficacy was assessed using the FLIE (Functional Living Index-Emesis) questionnaire, which measured the impact of nausea and vomiting on quality of life. Results: Out of 36 women initially interviewed; 30 participated in the study. In the control group, seven patients experienced moderate nausea on the first day after the first cnemotherapy session, and two reported severe nausea. After the cross-over, significant improvement in quality of life was observed, with a reduction in symptoms during the third and fourth cycles. Statistical analysis showed a significant p value (p < 0.05) for nausea reduction across different chemotherapy sessions. In the intervention group, no significant difference was observed between session scores, suggesting a lasting effect of Acupuncture during the last two sessions. Conclusions: Despite the limited sample size, this pilot study demonstrated that acupuncture, combined with pharmacological prophylaxis, improved the quality of life for patients experiencing CINV. Acupuncture performed from the first chemotherapy session may have a lasting effect in reducing nausea and vomiting. Further studies with larger sample sizes are recommended to validate these findings.