Acupuncture and moxibustion improve leukopenia caused by chemo and radiotherapy

 Tiejun Tang

Leukopenia is one of the most common side effects of chemo and radiotherapy in cancer treatment. When the level of white blood cell (WBC) count is too low, chemo or radiotherapy has to be terminated to avoid fatal uncontrollable infection. If the chemo or radiotherapy plan is not completed, the remaining tumor cells will recur, leading to treatment failure. This is a difficult situation that western medicine doctors have to face in tumor treatment.

Can Chinese medicine help in this situation? The following research reports give a positive answer:

A randomized controlled trial (RCT), published in the journal Supportive Care in Cancer in 2014^[1], found that acupuncture combined with moxibustion was more effective than medication in increasing WBCs counts in breast cancer patients undergoing chemotherapy. Another study, published in the Journal of Traditional Chinese Medicine in 2012 ^[2], found that moxibustion was effective in preventing leukopenia in lung cancer patients undergoing chemotherapy.

A Meta-analysis research which Leukopenia is one of the most common side effects of chemo and radiotherapy in cancer treatment. When the level of white blood cell (WBC) count is too low, chemo or radiotherapy has to be terminated to avoid fatal uncontrollable infection. If the chemo or radiotherapy plan is not completed, the remaining tumor cells will recur, leading to treatment failure. This is a difficult situation that western medicine doctors have to face in tumor treatment.

Can Chinese medicine help in this situation? The following research reports give a positive answer:

A randomized co include 15 RCTs 1130 patients, the results showed that acupuncture can increase WBC count after chemotherapy (P <0 .00001), reduce the incidence of myelosuppression (P = 0.0002), and improve the clinical treatment effectiveness (P = 0.05). The differences were statistically significant^{. [3]}

A RCT involving 650 breast cancer patients were eligible for inclusion. Analysis by the random-effects model showed a significant effect by acupuncture of ameliorating leucopoenia during chemotherapy. Levels of WBCs were increased (P < 0.001) neutrophil counts (P < 0.001) were significantly enhanced. Moreover, regardless of the manner through which acupuncture was applied, overall values of WBCs increased. ^[4]

A Six RCTs with a total of 681 patients with various types of cancer receiving ongoing chemotherapy or after chemotherapy. The results of two RCTs suggested the effectiveness of moxibustion combined with chemotherapy vs. chemotherapy alone. Six RCTs showed that moxibustion was more effective than various types of control interventions in increasing WBC counts. ^[5]

The exact mechanisms by which acupuncture and moxibustion work to alleviate leukopenia are not yet fully understood. However, it is believed that they may help stimulate the immune system and increase the production of WBCs. They may also help reduce inflammation and oxidative stress, both of which can contribute to leukopenia.

Except acupuncture Chinese herbal medicines also can prevent and treat the bone marrow suppression caused by chemo and radiotherapy, and increase the WBCs count. I used wrote an article on this topic in 2010. ( Click the link to read more). In a recent, meta-analysis research which included of 14 RCT involving 1,053 patients the results showed that Chinese herbal medicine + chemotherapy had greater beneficial effects on WBC, neutrophil , hemoglobin and platelet counts. Compared with chemotherapy alone or western medicine + chemotherapy, Chinese herbal medicine combined with chemotherapy can effectively improve the clinical symptoms of chemotherapy-induced leukopenia^{. [6]}

It is important to note that acupuncture and moxibustion should not be used as a substitute for conventional cancer treatment, but they can be used as a complementary therapy to help alleviate side effects of chemo and radiotherapy.

In conclusion, acupuncture and moxibustion have shown promise in the treatment of leukopenia caused by chemo and radiotherapy. The combination of acupuncture and herbal medicine will lead a double effect in the clinical. The intervention of this complementary medicine therapy can often affect the prognosis of cancer treatment

References:       

1.  Lu, W.Acupuncture and moxibustion for chemotherapy-induced leukopenia: a randomized controlled trial. Supportive Care in Cancer. 2014; 22(6), 1733-1738.
2. Chen, X.Clinical observation of moxibustion in preventing chemotherapy-induced leukopenia in lung cancer patients. Journal of Traditional Chinese Medicine.2012; 32(3), 343-346.
3.  Jiayun Nian. Efficacy and safety of acupuncture for chemotherapy-induced leukopenia: A systematic review and meta-analysis. Medicine (Baltimore). 2022; 21;101(42):e30995.
4.  Ya Wen Shih. Effectiveness of Acupuncture in Relieving Chemotherapy-induced Leukopenia in Patients With Breast Cancer: A Systematic Review With A Meta-Analysis and Trial Sequential Analysis. Integr Cancer Ther. 2021 Jan-Dec;20:15347354211063884.
5. Tae-Young Choi. Moxibustion for the treatment of chemotherapy-induced leukopenia: a systematic review of randomized clinical trials. Support Care Cancer. 2015 Jun;23(6):1819-26
6.  Qing Wang. Chinese Herbal Medicine for Chemotherapy-Induced Leukopenia: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials. Front Pharmacol. 2021 May 4;12:573500.