Auricular point acupressure for chemotherapy-induced peripheral neuropathy: a randomized controlled trial.
15 affiliations
- 1School of Nursing, Johns Hopkins University, 525 North Wolfe Street, Baltimore, MD, 21205, USA. [email protected].
- 2Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA. [email protected].
- 3School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
- 4School of Nursing, Johns Hopkins University, 525 North Wolfe Street, Baltimore, MD, 21205, USA.
- 5Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA.
- 6McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
- 7Department of Psychiatry and Behavioral Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- 8Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- 9Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- 10Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- 11Department of Psychology, Ohio University, Athens, OH, USA.
- 12Faculty of Nursing, Mahidol University, Bangkok, Thailand.
- 13Department of Pain Medicine, Division of Anesthesiology, Critical Care & Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- 14Department of Nursing, M. D. Anderson Cancer Center, The University of Texas, Houston, TX, USA.
- 15Department of Population Health Science, University of Texas Health Science at San Antonio, San Antonio, TX, USA.
Abstract
Purpose
Chemotherapy-induced peripheral neuropathy (CIPN) is common and persistent, with limited management options. This trial primarily examines whether auricular point acupressure (APA) improved CIPN outcomes versus usual care; a secondary pragmatic aim compared in-person mobile support (mAPA) with virtual (vAPA) delivery.Methods
Two hundred twenty-seven cancer survivors with CIPN were randomized to mAPA (n = 80), vAPA (n = 75), or usual care (n = 72). Both APA arms received the same 4-week auricular point protocol; mAPA received in-person seed placement, and vAPA received video instruction for self-placement, with one coaching session for both. Usual care was standard oncologic and supportive care with no study-delivered APA. Primary outcome was a ≥20% reduction from baseline in an individualized composite outcome (ICO); each participant's highest-rated symptom-by-location item at baseline. Secondary outcomes were neuropathy interference, functional status, and quality of life. Intention-to-treat analyses used generalized estimating equations with multiple imputation and delta-adjusted sensitivity analyses.Results
At Week 1, both APA arms exceeded usual care (mAPA OR = 2.60, 95% CI 1.27-5.33; vAPA OR = 3.22; 95% CI 1.48-7.01; p < 0.01). The mAPA advantage persisted at Week 2 (OR = 2.49, p = 0.02). For neuropathy interference, mAPA benefits exceeded usual care every week (OR = 3.29-4.28, all p < 0.01). Among exploratory domains, anxiety, depression, and pain interference improved only in mAPA.Conclusion
APA produced a short-lived advantage in CIPN severity and more consistent improvement in interference, specifically with in-person delivery. Findings are preliminary: no blinding or attention control, differential attrition (52% vAPA versus 96% usual care), and exploratory quality-of-life analyses.Trial registration
ClinicalTrials.gov, ID NCT04920097 registered on 3 June 2021.
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BibTeX
@article{lukkahatai2026auricular,
title = {{Auricular point acupressure for chemotherapy-induced peripheral neuropathy: a randomized controlled trial.}},
author = {Nada Lukkahatai and Yannuo Jiang and Jingyu Zhang and Jennifer Kawi and Hulin Wu and Hongyu Wang and Claudia M Campbell and Johannes Thrul and Haris Sair and Katrina R Hamilton and Yumin Cho and Chitchanok Benjasirisan and Salahadin Abdi and Eileen D Hacker and Syed H Jafri and Putao Cen and Anneliese Gonzalez and Neha Maithel and Julie Rowe and Lavanya H Palavalli Parsons and Jessica Jones and Constance M Johnson and Thomas J Smith},
journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer},
year = {2026},
month = oct,
doi = {10.1007/s00520-026-11373-8},
url = {https://europepmc.org/article/MED/42961520},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Auricular point acupressure for chemotherapy-induced peripheral neuropathy: a randomized controlled trial.
AU - Nada Lukkahatai
AU - Yannuo Jiang
AU - Jingyu Zhang
AU - Jennifer Kawi
AU - Hulin Wu
AU - Hongyu Wang
AU - Claudia M Campbell
AU - Johannes Thrul
AU - Haris Sair
AU - Katrina R Hamilton
AU - Yumin Cho
AU - Chitchanok Benjasirisan
AU - Salahadin Abdi
AU - Eileen D Hacker
AU - Syed H Jafri
AU - Putao Cen
AU - Anneliese Gonzalez
AU - Neha Maithel
AU - Julie Rowe
AU - Lavanya H Palavalli Parsons
AU - Jessica Jones
AU - Constance M Johnson
AU - Thomas J Smith
PY - 2026
DA - 2026/10/30
JO - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
DO - 10.1007/s00520-026-11373-8
UR - https://europepmc.org/article/MED/42961520
AB - Purpose Chemotherapy-induced peripheral neuropathy (CIPN) is common and persistent, with limited management options. This trial primarily examines whether auricular point acupressure (APA) improved CIPN outcomes versus usual care; a secondary pragmatic aim compared in-person mobile support (mAPA) with virtual (vAPA) delivery.Methods Two hundred twenty-seven cancer survivors with CIPN were randomized to mAPA (n = 80), vAPA (n = 75), or usual care (n = 72). Both APA arms received the same 4-week auricular point protocol; mAPA received in-person seed placement, and vAPA received video instruction for self-placement, with one coaching session for both. Usual care was standard oncologic and supportive care with no study-delivered APA. Primary outcome was a ≥20% reduction from baseline in an individualized composite outcome (ICO); each participant's highest-rated symptom-by-location item at baseline. Secondary outcomes were neuropathy interference, functional status, and quality of life. Intention-to-treat analyses used generalized estimating equations with multiple imputation and delta-adjusted sensitivity analyses.Results At Week 1, both APA arms exceeded usual care (mAPA OR = 2.60, 95% CI 1.27-5.33; vAPA OR = 3.22; 95% CI 1.48-7.01; p < 0.01). The mAPA advantage persisted at Week 2 (OR = 2.49, p = 0.02). For neuropathy interference, mAPA benefits exceeded usual care every week (OR = 3.29-4.28, all p < 0.01). Among exploratory domains, anxiety, depression, and pain interference improved only in mAPA.Conclusion APA produced a short-lived advantage in CIPN severity and more consistent improvement in interference, specifically with in-person delivery. Findings are preliminary: no blinding or attention control, differential attrition (52% vAPA versus 96% usual care), and exploratory quality-of-life analyses.Trial registration ClinicalTrials.gov, ID NCT04920097 registered on 3 June 2021.
SN - 0941-4355
SN - 1433-7339
ER -