A randomised study of the value of acupuncture in treating non small cell lung cancer and mesothelioma patients with dyspnoea

ISRCTN ISRCTN34841555
DOI https://doi.org/10.1186/ISRCTN34841555
Protocol serial number N/A
Sponsor Royal Marsden Hospital (UK)
Funder Royal Marsden Hospital (UK)
Submission date
09/02/2006
Registration date
23/02/2006
Last edited
23/03/2018
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, making up around 85-90% of all cases. As the health of the lungs deteriorates, many patients experience breathlessness, as their lungs are no longer able to function properly. This can be painful and distressing to sufferers, as constant breathlessness, even while at rest, can prevent them from taking part in many activities. Currently, the only medical treatment offered for these patients is morphine (a powerful pain-relieving drug), although this is not thought to help particularly and has many unwanted side-effects. Acupuncture is a popular treatment taken from ancient Chinese medicine, in which fine needels are placed into the body at specific points. Studies have shown that it can help to stimulate nerves under the skin, causing the body to produce natural pain-relieving substances (endorphins). There is evidence that it is effective in a range of conditions, including problems with breathing. The aim of this study is to find out whether acupuncture treatment can help to relieve breathlessness in patients suffering from NSCLC.

Who can participate?
Adult patients with non-small cell lung cancer (NSCLC) who experience breathlessness at rest.

What does the study involve?
Participants are randomly allocated to one of three groups. Those in the first group are given morphine for pain relief only. Those in the second group are given acupuncture treatment. This involves an initial session of acupuncture, where thin needles are placed in the skin in specific places, followed by the semi-permanent acupuncture studs being placed into the skin that are to be left in place for 14 days. Those in the third group are given morphine as well as acupuncture treatment in the same way as the second group. All participants attend study visits at the start of the study and then after 7 and 14 days to complete a physical assessment to measure breathlessness and a number of questionnaires to assess their mood and wellbeing.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
Royal Marsden Hospital (UK)

When is the study starting and how long is it expected to run for?
May 2006 to January 2014

Who is funding the study?
Royal Marsden Hospital (UK)

Who is the main contact?
Dr Mary O’Brien

Contact information

Dr Mary O'Brien
Scientific

Royal Marsden Hospital
Downs road
Sutton
SM2 5PT
United Kingdom

Study information

Primary study designInterventional
Study designRandomised phase II trial
Secondary study designRandomised controlled trial
Study type Participant information sheet
Scientific titleA randomised study of the value of acupuncture in treating non small cell lung cancer and mesothelioma patients with dyspnoea
Study objectivesSome studies on breathlessness, while small, have shown acupuncture to have a significant positive effect in the perception of breathlessness in end-stage cancer, chronic obstructive pulmonary disease and asthma. The vast majority of trials of acupuncture for breathlessness have been performed in a non-cancer setting. Therefore, the lack of data regarding effectiveness of acupuncture and standard opioids for cancer-related dyspnoea, together with drawbacks associated with opioid use and service acupuncture in the National Health Service (NHS) for this indication, warrant further research.
Ethics approval(s)Royal Marsden Research Ethics Committee, May 2006
Health condition(s) or problem(s) studiedNon-small cell lung cancer and mesothelioma
InterventionPatients are randomised to receive one of the following interventions:
1. Morphine
2. Acupuncture
3. Morphine and acupuncture

After completing baseline assessments patients will undergo treatment on day one according to which treatment arm they have been randomized to. Those in treatment arms two and three will have indwelling acupuncture studs inserted after their initial acupuncture treatment. During the course of day 1 all patients will undergo further assessments after their initial treatment. All patients will return for assessment on days 7 and 14 (this last visit marks the end of trial). Those patients who feel a beneficial effect of the acupuncture studs will be allowed to retain them and followed up in the usual outpatient clinic.
Intervention typeMixed
Primary outcome measure(s)

The effectiveness of acupuncture for relief of breathlessness in lung cancer

Key secondary outcome measure(s)

1. Measures of anxiety, relaxation, other subjective variables (Lar scales)
2. Respiratory rate and lung function tests (Forced Expiratory Volume [FEV], Partial Expiratory Flow Rate [PEFR])
3. Hospital Anxiety and Depression (HAD) Scale
4. Quality of Life (QOL) changes between baseline and 7 days

Completion date31/01/2014

Eligibility

Participant type(s)Patient
Age groupAdult
SexAll
Target sample size at registration174
Key inclusion criteriaPatients with a diagnosis of Non Small Cell Lung Cancer (NSCLC) and mesothelioma and breathless at rest with at least a Visual Analogue Scale (VAS) score >/= 4, or breathlessness at rest
Key exclusion criteria1. Recent acupuncture in the last four weeks
2. Contraindications to acupuncture e.g bleeding abnormality or anticoagulation
3. Current use of morphine in any form (oral or nebuliser) at study entry
4. Untreated reversible anaemia, pleural effusion, pulmonary embolism, pneumonia, ascites, or superior vena cava obstruction, if treatment appropriate
5. Pregnancy
6. Commenced oral or inhaled steroids or changed dose within one week of the start of the study
7. Chemotherapy or radiotherapy or change in hormonotherapy in the last four weeks
Date of first enrolment01/05/2006
Date of final enrolment31/01/2014

Locations

Countries of recruitment

  • United Kingdom
  • England

Study participating centre

Royal Marsden Hospital
Sutton
SM2 5PT
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/07/2016 Yes No
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes

Editorial Notes

23/03/2018: Publication reference added.
05/02/2016: No publications found, verifying study status with principal investigator. Plain English summary added.
28/01/2013: The target number of participants was updated from 114 to 174 and the anticipated end date was updated from 31/12/2011 to 31/01/2014.
24/05/2011: The anticipated end date for this trial has been extended from 01/05/2007 to 31/12/2011.