Electroacupuncture for acute gastrointestinal symptoms during chemotherapy for colorectal cancer: a randomized clinical trial

BACKGROUND: Acute chemotherapy-related gastrointestinal symptoms can limit colorectal cancer treatment. We evaluated electroacupuncture as adjunctive care for acute gastrointestinal symptom burden during chemotherapy. METHODS: This multicenter, randomized, patient- and assessor-blinded, sham-controlled trial was conducted at 6 tertiary hospitals in China from July 2022 to August 2025. Adults with colorectal cancer and chemotherapy-related gastrointestinal symptoms were randomly assigned 1 1:1 to electroacupuncture, nonpenetrating sham acupuncture, or usual care. Treatments were given once daily for 3 days during chemotherapy. The primary outcome was change in Gastrointestinal Symptom Rating Scale (GSRS) total score from baseline to day 3. Secondary outcomes included rescue medication use and adverse events. RESULTS: Among 230 randomized patients (mean age, 60.1 years; 54.3% men), 211 (91.7%) completed the 3-day intervention. At day 3, electroacupuncture reduced GSRS total scores more than sham acupuncture (mean difference [MD], -1.54; 95% CI, -2.35 to -0.74; P < .001) and usual care (MD, -1.30; 95% CI, -2.09 to -0.50; P = .001). These differences did not exceed the prespecified minimal clinically important difference of 2.15 points. Electroacupuncture was associated with higher odds of remaining rescue-free than sham acupuncture (adjusted OR, 2.86; 95% CI, 1.23 to 6.63; P = .015) and usual care (adjusted OR, 2.64; 95% CI, 1.16 to 6.01; P = .021). No serious adverse events occurred. CONCLUSIONS: Electroacupuncture was associated with statistically significant but modest short-term reductions in acute gastrointestinal symptom burden. The between-group differences did not exceed the prespecified clinical-importance threshold and should be interpreted cautiously. TRIAL REGISTRATION: Chinese Clinical Trials Register identifier ChiCTR2200062317.