Electroacupuncture Frequency for Chemotherapy-Induced Neuropathy in Breast Cancer: A Randomized Controlled Trial

Abstract 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 2Hz, 100Hz, 2/100Hz 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 2/100Hz EA achieved the highest overall response rate. Both 2Hz EA and 2/100Hz EA improved PNQ sensory scores at week 4. Sensory scores improved across groups, while motor scores decreased with 2Hz EA and 2/100Hz EA. Only 2Hz EA improved autonomic function. For quality-of-life, 2Hz EA enhanced physical function, fatigue, pain and insomnia, while 2/100Hz EA improved nausea/vomiting, constipation, appetite and global health with additional pain relief at week 4. The 100Hz EA group showed no significant benefits in these domains. Conclusions This study preliminarily explored EA's potential benefits for CIPN, with 2/100Hz showing the highest response rate and 2Hz demonstrating sensory improvement advantages. Different frequencies produced distinct therapeutic profiles. Further research should evaluate frequency-specific effects of EA for CIPN. Implications for Practice We report an exploratory investigation of different electroacupuncture frequencies for managing peripheral neuropathy in breast cancer patients. Our observations suggest that frequency selection should be individualized based on symptom profiles. The data indicate that while 2/100Hz EA demonstrated the most comprehensive effects, 2Hz EA appeared particularly beneficial for sensory improvement, and 2/100Hz EA showed relevance for gastrointestinal symptoms and overall well-being. These clinical observations, though preliminary, may guide practitioners in tailoring EA frequency selection when addressing CIPN in this patient population.