The addition of traditional acupuncture and auricular acupressure to radiotherapy (RT) was associated with improved quality of life (QOL) in patients with head and neck squamous cell carcinoma (HNSCC), according to findings from a 2-arm, parallel, randomized clinical trial with blinded outcome assessment published in Cancers (ReBEC RBR-10v5gcdk).
Of 296 patients assessed for eligibility, 107 were randomly assigned 1:1 to acupuncture (n = 52) and or to a no-intervention control group (n = 55), with a final per-protocol analysis of 47 and 52 patients, respectively, after deaths and radiotherapy discontinuations during follow-up. No significant baseline differences in QOL or clinical characteristics were observed between groups.
The trial’s primary outcome, overall QOL by WHOQOL-BREF, improved significantly in the acupuncture group from a mean score of 53.41 (SD, 6.68) at baseline to 60.76 (SD, 6.28) after treatment (P <.000). The control group showed the opposite trajectory, declining from 56.85 (SD, 6.68) to 52.90 (SD, 8.63) over the same period.
Secondary outcomes for the physical, psychological, social, and environmental domains of the WHOQOL-BREF followed a similar pattern in the acupuncture group: physical scores rose from 49.39 (SD, 9.64) to 57.64 (SD, 9.76; P <.000); psychological scores rose from 50.88 (SD, 10.42) to 56.47 (SD, 10.49; P <.002); social scores rose from 67.55 (SD, 8.55) to 71.80 (SD, 9.60; P <.019); and environmental scores rose from 53.59 (SD, 8.39) to 60.41 (SD, 7.83; P <.000). The social domain was the only measure for which the group-by-time interaction did not reach significance. Corresponding scores declined across all 4 domains in the control group, and no significant adverse effects requiring medical evaluation were reported in either group.
“These contrasting trajectories suggest that acupuncture may help mitigate the expected deterioration in [QOL] during [RT] and may provide meaningful benefits from the patient’s perspective,” lead study author André Luiz Sena Guimarães, professor in the Department of Dentistry at Universidade Estadual de Montes Claros (Unimontes) and Dilson Godinho Hospital in Brazil, wrote in the publication with study coinvestigators.
Patients were enrolled at Dilson Godinho Hospital in Montes Claros, Brazil, between March 2017 and June 2018, with histologically confirmed HNSCC of the tongue, gingiva, floor of the mouth, palate, tonsil, oropharynx, pyriform sinus, or hypopharynx. They underwent 3-D RT alone or combined with chemotherapy and/or surgery. The intervention group received 18 needles weekly throughout RT at a standardized set of body points, retained for 20 minutes with manual restimulation every 5 minutes to maintain the de qi response, plus auricular acupressure using mustard seeds at 7 ear points, alternating ears weekly. The control group received no acupuncture.
The primary end point was the overall QOL score assessed by the WHOQOL-BREF; secondary end points were the physical, psychological, social, and environmental domain scores of the same instrument, each compared between baseline and the end of RT.
The study did not include a sham-acupuncture control, and complete blinding was not feasible given the nature of the intervention, so expectancy effects on patient-reported outcomes could not be fully excluded. Objective measures such as xerostomia severity, dysphagia scoring, and mucositis grading were not incorporated, and biological markers were not assessed, limiting conclusions about mechanism.
The authors noted their findings are broadly consistent with prior work on acupuncture’s positive impact on well-being and reduced analgesic use in cancer populations, although some studies have failed to show significant improvement in emotional, social, and overall QOL despite gains in specific symptoms like xerostomia. They suggested that randomized trials with larger samples, longer follow-up, and sham-controlled designs are needed to clarify acupuncture’s mechanisms and optimal protocols in supportive cancer care.
Reference
Menezes AS, Sanches GL, Durães CP, et al. Acupuncture to improve quality of life in patients with head and neck cancer: a randomized clinical trial. Cancers. 2026;18(13):2132. doi:10.3390/cancers18132132
