Acupuntura no manejo da dor de pacientes oncológicos

Authors

  • Andrei Esteves dos Reis Bonfante
  • Ana Paula Machado da Rocha

DOI:

https://doi.org/10.34119/bjhrv6n2-153

Keywords:

acupuntura, dor, Câncer

Abstract

A acupuntura é uma técnica há muito tempo utilizada no tratamento de doenças na Medicina Tradicional Chinesa. O mecanismo de ação da acupuntura parece envolver ativação de vias opioidérgicos, adrenérgicos, serotoninérgicos, colinérgicos e GABAérgicos, mas ainda não está claro. No entanto, sua eficácia no manejo da dor tem sido continuamente confirmada em diversos trabalhos.  Justamente por esta razão, o uso da terapia por acupuntura no tratamento da dor oncológica tem se elevado. A dor é sintoma clínico frequente e mais difícil de se lidar no tratamento do câncer. Seja proveniente da própria doença ou decorrente do tratamento quimioterápico e/ou radiológico, o alívio da dor oncológica envolve, geralmente, o uso analgésico opioides, os quais estão associados a vários problemas como abusos e vícios, overdoses acidentais e/ou depressão respiratória. Diversos trabalhos apontam que o uso da acupuntura na dor oncológica reduz a necessidade de opioides, além de promover reduzir concomitantemente outros sintomas decorrentes do tratamento do câncer. Esse trabalho, visa apresentar uma revisão de literatura sobre acupuntura e apontar como esse tratamento pode ser de grande auxílio no manejo da dor nos cuidados paliativos.

References

BÄUMLER, P. et al. Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies. BMJ Open, v. 11, n. 9, 2021.

BAO, T. et al. Acupuncture versus medication for pain management: a cross-sectional study of breast cancer survivors. Acupuncture in medicine : journal of the British Medical Acupuncture Society, v. 36, n. 2, p. 80, abr. 2018a.

BAO, T. et al. A Phase IIA Trial of Acupuncture to Reduce Chemotherapy-Induced Peripheral Neuropathy Severity During Neoadjuvant or Adjuvant Weekly Paclitaxel Chemotherapy in Breast Cancer Patients. European journal of cancer (Oxford, England : 1990), v. 101, p. 12, set. 2018b.

BEN-ARIE, E. et al. Digestion-Specific Acupuncture Effect on Feeding Intolerance in Critically Ill Post-Operative Oral and Hypopharyngeal Cancer Patients: A Single-Blind Randomized Control Trial. Nutrients, v. 13, n. 6, jun. 2021.

BRASILEIRO FILHO, G. Bogliolo: patologia geral. 6. ed. Rio de Janeiro : Guanabara: EDITORA GUANABARA KOOGAN LTDA., 2019.

CAGNIE, B. et al. Physiologic effects of dry needling. Current pain and headache reports, v. 17, n. 8, ago. 2013.

COUTINHO, B. D.; DULCETTI, P. G. S. O movimento Yīn e Yáng na cosmologia da medicina chinesa. História, Ciências, Saúde-Manguinhos, v. 22, p. 797–811, set. 2015.

CHAN, Y.-T. et al. Systematic Review with Meta-Analysis: Effectiveness and Safety of Acupuncture as Adjuvant Therapy for Side Effects Management in Drug Therapy-Receiving Breast Cancer Patients. Evidence-based Complementary and Alternative Medicine : eCAM, v. 2021, 2021.

CHEN, S. et al. Acupuncture for visceral pain: neural substrates and potential mechanisms. Evidence-based complementary and alternative medicine : eCAM, v. 2014, p. 609594, 2014.

CHIEN, T.-J. et al. The Efficacy of Acupuncture in Chemotherapy-Induced Peripheral Neuropathy: Systematic Review and Meta-Analysis. Integrative Cancer Therapies, v. 18, 2019.

DENG, G. Integrative Medicine Therapies for Pain Management in Cancer Patients. Cancer journal (Sudbury, Mass.), v. 25, n. 5, p. 343, out. 2019.

DJAALI, W.; SIMADIBRATA, C. L.; NARESWARI, I. Acupuncture Therapy in Post-Radiation Head-and-Neck Cancer with Dysgeusia. Medical Acupuncture, v. 32, n. 3, p. 157, jun. 2020.

DYMACKOVA, R. et al. Effect of Acupuncture in Pain Management of Head and Neck Cancer Radiotherapy: Prospective Randomized Unicentric Study. Journal of Clinical Medicine, v. 10, n. 5, mar. 2021.

Feng, I. C.; Antochi, A.D.; Barbilian, A.G. Acupuncture and the retrospect of its modern research. Romanian journal of morphology and embryology, v. 60, n. 2, 2019.

GARCIA, J. B. S.; CARDOSO, M. G. DE M.; DOS-SANTOS, M. C. Opioides e o sistema imunológico: relevância clínica. Revista Brasileira de Anestesiologia, v. 62, p. 713–718, out. 2012.

GARCIA, M. K. et al. Effect of True and Sham Acupuncture on Radiation-Induced Xerostomia Among Patients With Head and Neck Cancer: A Randomized Clinical Trial. JAMA Network Open, v. 2, n. 12, dez. 2019.

GE, L. et al. Acupuncture for cancer pain: an evidence-based clinical practice guideline. Chinese Medicine, v. 17, 2022.

GOODMAN, L. S. et al. Goodman & Gilman’s pharmacological basis of therapeutics. 12th ed ed. New York: McGraw-Hill, 2011.

HALL, M. V.; DYDYK, A. M.; GREEN, M. S. Acupuncture. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2022.

HAUCK, M. et al. Acupuncture analgesia involves modulation of pain-induced gamma oscillations and cortical network connectivity. Scientific reports, v. 7, n. 1, p. 16307, 24 nov. 2017.

HE, Y. et al. Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain: A Systematic Review and Meta-Analysis. JAMA Oncology, v. 6, n. 2, p. 271, fev. 2020.

HERMANUSSEN, S.; DO, M.; CABOT, P. J. Reduction of beta-endorphin-containing immune cells in inflamed paw tissue corresponds with a reduction in immune-derived antinociception: reversible by donor activated lymphocytes. Anesthesia and Analgesia, v. 98, n. 3, p. 723–729, table of contents, mar. 2004.

HERSHMAN, D. L. et al. Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer: A Randomized Clinical Trial. JAMA, v. 320, n. 2, p. 167, 7 jul. 2018.

HUANG, C.-C. et al. Acupuncture Relieved Chemotherapy-Induced Peripheral Neuropathy in Patients with Breast Cancer: A Pilot Randomized Sham-Controlled Trial. Journal of Clinical Medicine, v. 10, n. 16, ago. 2021.

HUANG, L.; ZHAO, Y.; XIANG, M. Knowledge Mapping of Acupuncture for Cancer Pain: A Scientometric Analysis (2000–2019). Journal of Pain Research, v. 14, p. 343, 2021.

INCA, Instituto Nacional de Câncer José Alencar Gomes da Silva. ABC do câncer: abordagens básicas para o controle do câncer. n. 2, p. 129, Rio de Janeiro. 2012.

INCA - Instituto Nacional de Câncer José Alencar Gomes da Silva. Como surge o câncer? Disponível em: <https://www.inca.gov.br/como-surge-o-cancer>. Acesso em: 10 jan. 2022.

INCA - Instituto Nacional de Câncer José Alencar Gomes da Silva. Radioterapia. Disponível em: <https://www.gov.br/inca/pt-br/assuntos/cancer/tratamento/radioterapia>. Acesso em 17 ago. 2022.

IRAVANI, S. et al. Effectiveness of Acupuncture Treatment on Chemotherapy-Induced Peripheral Neuropathy: A Pilot, Randomized, Assessor-Blinded, Controlled Trial. Pain Research & Management, v. 2020, 2020.

IRMAN; HELIANTHI, D. R. The Roles of Battlefield Acupuncture and Electroacupuncture in a Patient with Cancer-Related Pain. Medical Acupuncture, v. 32, n. 4, p. 234, ago. 2020.

JANG, A. et al. The Effects of Acupuncture on Cancer-Related Fatigue: Updated Systematic Review and Meta-Analysis. Integrative Cancer Therapies, v. 19, 2020.

JIN, Y. et al. Efficacy and Safety of Acupuncture against Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis. Evidence-based Complementary and Alternative Medicine : eCAM, v. 2020, 2020.

KIM, K.; LEE, S. Intradermal Acupuncture Along with Analgesics for Pain Control in Advanced Cancer Cases: A Pilot, Randomized, Patient-Assessor-Blinded, Controlled Trial. Integrative Cancer Therapies, v. 17, n. 4, p. 1137, dez. 2018.

KUANG, R. et al. Efficacy and safety of acupuncture combined with analgesics on lung cancer pain: A protocol for systematic review and meta-analysis. Medicine, v. 100, n. 23, p. e26225, 11 jun. 2021.

LI, S. et al. Clinical Efficacy and Potential Mechanisms of Acupoint Stimulation Combined With Chemotherapy in Combating Cancer: A Review and Prospects. Frontiers in Oncology, v. 12, 2022.

LI, Y.-F. et al. ATAS Acupuncture Reduces Chemotherapy Induced Fatigue in Breast Cancer Through Regulating ADROA1 Expression: A Randomized Sham-Controlled Pilot Trial. OncoTargets and therapy, v. 13, p. 11743, 2020.

LIN, L. et al. Acupuncture-Induced Analgesia: The Role of Microglial Inhibition. Cell transplantation, v. 25, n. 4, p. 621–628, 2016.

LIOU, K. T. et al. What if Acupuncture Were Covered by Insurance for Pain Management? A Cross-Sectional Study of Cancer Patients at One Academic Center and 11 Community Hospitals. Pain Medicine: The Official Journal of the American Academy of Pain Medicine, v. 20, n. 10, p. 2060, out. 2019.

LIOU, K. T. et al. Fear of Analgesic Side Effects Predicts Preference for Acupuncture: A Cross-Sectional Study of Cancer Patients with Pain in the United States. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, v. 29, n. 1, p. 427, jan. 2021.

LU, W. et al. Recent Advances in Oncology Acupuncture and Safety Considerations in Practice. Current treatment options in oncology, v. 11, n. 3–4, p. 141, dez. 2010a.

LU, W. et al. Acupuncture for Chemotherapy‐Induced Peripheral Neuropathy in Breast Cancer Survivors: A Randomized Controlled Pilot Trial. The Oncologist, v. 25, n. 4, p. 310, abr. 2020b.

MAO, J. J. et al. Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors: The PEACE Randomized Clinical Trial. JAMA Oncology, v. 7, n. 5, p. 1, maio 2021.

MIAO, X. et al. Clinical Efficacy of Acupuncture on Neoadjuvant Chemotherapy with Capecitabine plus Paclitaxel and Radiotherapy in Progressive Gastric Cancer. Journal of Oncology, v. 2022, 2022.

MOLASSIOTIS, A. et al. A Randomized Assessor-Blinded Wait-List-Controlled Trial to Assess the Effectiveness of Acupuncture in the Management of Chemotherapy-Induced Peripheral Neuropathy. Integrative Cancer Therapies, v. 18, 2019.

NI, X. et al. Acupuncture for Radiation-Induced Xerostomia in Cancer Patients: A Systematic Review and Meta-Analysis. Integrative Cancer Therapies, v. 19, 2020.

NIH, CONSENSUS DEVELOPMENT PANEL ON ACUPUNCTURE. Acupuncture. JAMA, v. 280, n. 17, p. 1518–1524, 4 nov. 1998.

ROCHA, S. P. et al. A trajetória da introdução e regulamentação da acupuntura no Brasil: memórias de desafios e lutas. Ciência & Saúde Coletiva, v. 20, p. 155–164, jan. 2015.

SCOGNAMILLO-SZABÓ, M. V. R.; BECHARA, G. H. Acupuntura: bases científicas e aplicações. Ciência Rural, v. 31, p. 1091–1099, dez. 2001.

SERÇE, S. et al. The Effect of Acupressure on Pain in Cancer Patients With Bone Metastasis: A Nonrandomized Controlled Trial. Integrative Cancer Therapies, v. 17, n. 3, p. 728, set. 2018.

SHIH, Y. W. et al. Effectiveness of Acupuncture in Relieving Chemotherapy-induced Leukopenia in Patients With Breast Cancer: A Systematic Review With A Meta-Analysis and Trial Sequential Analysis. Integrative Cancer Therapies, v. 20, 2021.

TAFFAREL, M. O.; FREITAS, P. M. C. Acupuntura e analgesia: aplicações clínicas e principais acupontos. Ciência Rural, v. 39, p. 2665–2672, dez. 2009.

TONG, T. et al. Efficacy of Acupuncture Therapy for Chemotherapy-Related Cognitive Impairment in Breast Cancer Patients. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, v. 24, p. 2919, 2018.

VIEL, E. et al. Efficacy of Auricular Acupuncture in Chemotherapy-Induced Peripheral Neuropathy: A Case Series of 73 Cases. Medical Acupuncture, v. 33, n. 3, p. 212, jun. 2021.

WEN, T. S.; HSING, W. T. Manual terapêutico de acupuntura. Barueri, SP: Manoele Ltda., 2008.

WHO - WORLD HEALTH ORGANIZATION. Cancer. Disponível em: <https://www.who.int/news-room/fact-sheets/detail/cancer>. Acesso em: 09 jan. 2022.

WITT, C. M. et al. Safety of Acupuncture: Results of a Prospective Observational Study with 229,230 Patients and Introduction of a Medical Information and Consent Form. Complementary Medicine Research, v. 16, n. 2, p. 91–97, 2009.

YAMAMURA, Y.; YAMAMURA, M. L. Guia de acupuntura. 1. ed. Barueri, SP: Manoele Ltda., 2015.

YAN, Z. et al. Acupuncture as a Complementary Therapy for Cancer-Induced Bone Pain: A Systematic Review and Meta-Analysis. Frontiers in Pain Research, v. 3, 2022.

YANG, P. et al. Acupuncture for opioid-induced constipation: Protocol for a systematic review and meta-analysis. Medicine, v. 99, n. 49, 12 dez. 2020.

YANG, Y.; WEN, J.; HONG, J. The Effects of Auricular Therapy for Cancer Pain: A Systematic Review and Meta-Analysis. Evidence-based Complementary and Alternative Medicine : eCAM, v. 2020, 2020.

YLVA, W.; PER, F.; ANNA, E. Acupuncture in Patients Undergoing Cancer Therapy: Their Interest and Belief in Acupuncture is High, But Few are Using It. Integrative Cancer Therapies, v. 21, 2022.

YOON, S. Y.; OH, J. Neuropathic cancer pain: prevalence, pathophysiology, and management. The Korean Journal of Internal Medicine, v. 33, n. 6, p. 1058, nov. 2018.

ZENG, J. et al. Clinical evidence of acupuncture and related therapy in patients with cancer-pain: A protocol for systematic review and meta-analysis. Medicine, v. 99, n. 45, 11 nov. 2020.

ZHANG, R. et al. Mechanisms of Acupuncture-Electroacupuncture on Persistent Pain. Anesthesiology, v. 120, n. 2, p. 482, fev. 2014.

ZHANG, Y. et al. Acupuncture for Breast Cancer: A Systematic Review and Meta-Analysis of Patient-Reported Outcomes. Frontiers in Oncology, v. 11, 2021.

ZHAO, Y.-X. et al. Acupuncture for Paclitaxel-Induced Peripheral Neuropathy: A Review of Clinical and Basic Studies. Journal of Pain Research, v. 14, p. 993, 2021.

ZIA, F. Z. et al. The National Cancer Institute’s Conference on Acupuncture for Symptom Management in Oncology: State of the Science, Evidence, and Research Gaps. Journal of the National Cancer Institute. Monographs, v. 2017, n. 52, nov. 2017.

Published

03/28/2023

How to Cite

BONFANTE, A. E. dos R.; DA ROCHA, A. P. M. Acupuntura no manejo da dor de pacientes oncológicos. Brazilian Journal of Health Review, [S. l.], v. 6, n. 2, p. 6366–6382, 2023. DOI: 10.34119/bjhrv6n2-153. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/58453. Acesso em: 19 oct. 2026.

Issue

Section

Original Papers