Electroacupuncture frequency for chemotherapy-induced neuropathy in breast cancer: a randomized controlled trial

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent dose-limiting toxicity in breast cancer patients. Electroacupuncture (EA) shows promise but optimal stimulation parameters remain undefined. We conducted a randomized trial comparing EA frequencies for CIPN. METHODS: This single-center, single-blind trial randomized patients to 2, 100, and 2/100 Hz EA, or mecobalamin (Mecbl). The primary outcome was the patient neurotoxicity questionnaire (PNQ) response rate at Week 4. Secondary outcomes included PNQ scores, National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) grades at Weeks 4/8, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (EORTC QLQ-CIPN20) and Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scales. RESULTS: 2/100 Hz EA achieved the highest overall response rate. Both 2 and 2/100 Hz EA improved PNQ sensory scores at Week 4. Sensory scores improved across groups, while motor scores decreased with 2 and 2/100 Hz EA. Only 2 Hz EA improved autonomic function. For quality-of-life, 2 Hz EA enhanced physical function, fatigue, pain and insomnia, while 2/100 Hz EA improved nausea/vomiting, constipation, appetite and global health with additional pain relief at Week 4. The 100 Hz EA group showed no significant benefits in these domains. CONCLUSIONS: This study preliminarily explored EA's potential benefits for CIPN, with 2/100 Hz showing the highest response rate and 2 Hz demonstrating sensory improvement advantages. Different frequencies produced distinct therapeutic profiles. Further research should evaluate frequency-specific effects of EA for CIPN.