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.

Objective: The chemotherapy agent Utidelone (UTD1), as a novel option for drug-resistant breast cancer patients, is prone to cause severe neurotoxicity. This study aims to evaluate the clinical effects of electroacupuncture (EA) and Mecobalamin (MeCbl) in treating Utidelone-induced peripheral neuropathy (UIPN), providing preliminary evidence to optimize clinical management strategies. Methods: A total of 60 eligible breast cancer patients with UIPN were randomly assigned in a 1:1 ratio to either the EA group or the MeCbl group. Evaluations were conducted after 4 weeks of treatment and again following a 4-week follow-up period (week 8). The primary outcome was the overall response rate of the Patient Neurotoxicity Questionnaire (PNQ), which was defined as a reduction of at least one grade in PNQ sensory or motor symptoms at week 4 compared to baseline. Secondary outcomes included the PNQ sensory, PNQ motor, and NCI-CTCAE grades, the EORTC QLQ-CIPN20 and QLQ-C30 scales. Results: 28 of 30 participants in the EA group and 29 of 30 participants in the MeCbl group completed the study. The responder rate of PNQ overall in the EA group was significantly higher than that in the MeCbl group at week 4 (P=0.015) and at week 8 (P=0.01). EA group exhibited significant improvements in PNQ sensory, PNQ motor, and NCI-CTCAE grades compared to baseline at week 4 (all P< 0.05). EA treatment also demonstrated the ability to alleviate UIPN symptoms and improve the quality of life in several aspects, as indicated by the EORTC QLQ-CIPN20 and QLQ-C30 scales. There were no serious treatment-related adverse events in either group. Conclusion: This randomized clinical trial indicated that EA therapy showed a potential benefit to alleviate symptoms of UIPN in breast cancer patients. Nevertheless, further research involving larger sample sizes and extended follow-up periods is warranted to elucidate these effects. Trial registration: No. ChiCTR2200062741.

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication in patients with cancer during chemotherapy. It mainly leads to severe numbness of the hands and feet and causes great pain in patients. Electroacupuncture (EA) is considered to be beneficial in improving peripheral neuropathy and relieving numbness of the hands and feet. This trial aims to evaluate the therapeutic effect of different frequencies of EA on CIPN in patients with cancer.Methods and analysis: This study is a randomized controlled trial. In total, 160 eligible CIPN patients are randomly assigned to the 2 Hz EA group, 100 Hz EA group, 2/100 Hz EA group, and control group in the ratio of 1:1:1:1. All patients in the EA treatment groups receive treatment with EA three times a week for 4 weeks and following up for 4 weeks. The patients in the control group are given Mecobalamin (MeCbl) tablets orally, one tablet at a time, three times a day, for 4 weeks, and following up for 4 weeks. The primary outcome measures are the participant neurotoxicity questionnaire (PNQ) and the peripheral neurotoxicity assessment rating (NCI CTCAE V5.0). Secondary outcomes are the quality of life scale (EORTC QLQ-C30) and the measurement of peripheral nerve conduction velocity (NCV). The results are evaluated at baseline, post-treatment phase, and following up for 4 weeks. All major analyses are based on the intention to treat principle.Ethics/dissemination: This protocol was approved by the Medical Ethics Committee of the Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) on 7 December 2021. The license number is IRB-2021-458. This study provides clinical efficacy data of different frequencies of EA in the treatment of CIPN. The results help to prove whether EA is an effective therapy for CIPN and optimize the frequency of EA for CIPN. The results of this study are shared with health care professionals, the public, and relevant organizations through the publication of manuscripts and conference reports.Trial registration number: ChiCTR2100054458.

Introduction: Oculomotor nerve palsy (ONP) is often discovered in the ophthalmology department, manifested as ptosis with the same side, eyeball in the fixed external booth, or accompanied by limited inward, upward, and downward movements. The present case report described the effect of electroacupuncture (EA) on a breast cancer patient with ONP after chemotherapy. Patient concerns: A 56-year-old breast cancer patient presented with severe ptosis and fixed right eye exotropia. Besides, it is challenging to perform the movement inward, upward, and downward, and with obvious diplopia. Diagnoses: The breast cancer patient was diagnosed with ONP, chemotherapy history. Interventions: The patient was introduced to acupuncture department to receiving EA treatment. Outcomes: After 12 times of EA treatments, the symptom of ptosis was significantly improved, and the right upper eyelid can lift autonomously as same as the left eye. Besides, the patient’s right lateral eye could move freely, and the symptoms of double vision disappeared. Conclusion: The case suggests that EA may be an effective alternative treatment for ONP.

There are factors that significantly increase the risk of postoperative pulmonary infections in patients with primary hepatic carcinoma (PHC). Previous reports have shown that over 10% of patients with PHC experience postoperative pul monary infections. Thus, it is crucial to prioritize the prevention and treatment of postoperative pulmonary infections in patients with PHC. To identify the risk factors for postoperative pulmonary infection in patients with PHC and develop a prediction model to aid in postoperative management. We retrospectively collected data from 505 patients who underwent hepatobiliary surgery between January 2015 and February 2023 in the Department of Hepatobiliary and Pancreaticospleen Surgery. Radiomics data were selected for statistical analysis, and clinical pathological parameters and imaging data were included in the screening database as candidate predictive variables. We then developed a pulmonary infection prediction model using three different models: An artificial neural network model; a random forest model; and a generalized linear regression model. Finally, we evaluated the accuracy and robustness of the prediction model using the receiver operating characteristic curve and decision curve analyses. Among the 505 patients, 86 developed a postoperative pulmonary infection, resulting in an incidence rate of 17.03%. Based on the gray-level co-occurrence matrix, we identified 14 categories of radiomic data for variable screening of pulmonary infection prediction models. Among these, energy, contrast, the sum of squares (SOS), the inverse difference (IND), mean sum (MES), sum variance (SUV), sum entropy (SUE), and entropy were independent risk factors for pulmonary infection after hepatectomy and were listed as candidate variables of machine learning prediction models. The random forest model algorithm, in combination with IND, SOS, MES, SUE, SUV, and entropy, demonstrated the highest prediction efficiency in both the training and internal verification sets, with areas under the curve of 0.823 and 0.801 and a 95% confidence interval of 0.766-0.880 and 0.744-0.858, respectively. The other two types of prediction models had prediction efficiencies between areas under the curve of 0.734 and 0.815 and 95% confidence intervals of 0.677-0.791 and 0.766-0.864, respectively. Postoperative pulmonary infection in patients undergoing hepatectomy may be related to risk factors such as IND, SOS, MES, SUE, SUV, energy, and entropy. The prediction model in this study based on diffusion-weighted images, especially the random forest model algorithm, can better predict and estimate the risk of pulmonary infection in patients undergoing hepatectomy, providing valuable guidance for postoperative management.