Abstract GS4-04: Randomized blinded sham- and waitlist-controlled trial of acupuncture for joint symptoms related to aromatase inhibitors in women with early stage breast cancer (S1200)
Notice bibliographique
Résumé
Abstract Background: Musculoskeletal symptoms are the most common side effect of aromatase inhibitors (AIs) and can result in decreased quality of life and discontinuation of therapy. Pilot data from two prior single institution studies showed that acupuncture decreased AI-induced joint symptoms in breast cancer (BC) patients. Methods: We conducted a SWOG multicenter randomized controlled trial among postmenopausal women with early stage BC. Patients taking an AI for ≥30 days and having a worst pain score of ≥3 out of 10 using the Brief Pain Inventory (BPI-WP) were eligible. Subjects were randomized at a 2:1:1 ratio to true acupuncture (TA) vs. sham acupuncture (SA) vs. waitlist control (WC). The TA protocol used a standardized protocol of body and auricular acupoints tailored to joint symptoms. The similarly standardized SA protocol utilized superficial needling of non-acupoints. Both the TA and SA protocols consisted of a 12 week intervention, with 12 sessions administered over 6 weeks, followed by 1 session per week for 6 additional weeks. The primary endpoint was change in the BPI-WP (worst pain) score at 6 weeks. Secondary outcomes included other BPI scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for the hips and knees, the Modified Score for the Assessment of Chronic Rheumatoid Affections of the Hands (M-SACRAH), and functional testing with grip strength and "Timed Get Up and Go" (TGUG). The design specified alpha=.025 two-sided tests to account for two independent comparisons (TA vs. SA and TA vs. WC). Results: Among 226 patients registered, 110 were randomized to TA, 59 to SA and 57 to WC. Baseline characteristics were similar between the groups. In a linear regression adjusting for the baseline score and stratification factors, 6-week mean BPI-WP scores were 0.92 points lower (correlating with less pain) in the TA compared to SA arm (95% CI: 0.20-1.65, p=.01), and were 0.96 points lower in the TA compared to WC arm (95% CI: 0.24-1.67, p=.01). The proportion of patients experiencing a clinically meaningful (>2) reduction (i.e. improvement) in BPI-WP was 58% for TA compared to 33% on SA and 31% on WC. Patients randomized to TA had improved symptoms compared to SA at week 6 according to all other BPI pain measures (average pain, p=.04; pain interference, p=.02; pain severity, p=.05; worst stiffness, p=.02). Results were similar compared to WC. Patients randomized to TA compared to SA or WC had statistically significant or marginally statistically significant improvements in BPI pain measures at week 12. Patients randomized to TA had generally improved symptoms compared to SA or WC at week 6 and at week 12 according to the M-SACRAH and WOMAC measures (p<0.05). With regard to adverse events, more patients on the TA arm experienced Grade 1 bruising compared to SA (47% vs. 25%, p=.01). No other differences by arm for selected adverse events were observed. Conclusions: This study was the first large multicenter trial to investigate the effect of acupuncture in treating AI-induced joint symptoms in BC patients. According to multiple measures, TA generated better outcomes than either SA or WC with minimal toxicity. Citation Format: Hershman DL, Unger JM, Greenlee H, Capodice J, Lew DL, Kengla AT, Melnik MK, Jorgensen CW, Kreisle WH, Minasian LM, Fisch MJ, Henry L, Crew KD. Randomized blinded sham- and waitlist-controlled trial of acupuncture for joint symptoms related to aromatase inhibitors in women with early stage breast cancer (S1200) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr GS4-04.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».