Effects of transcutaneous electrical acupoint stimulation on health-related quality of life in cancer patients receiving chronic opioid therapy: A secondary analysis from a randomized clinical trial

Background Cancer-related pain (CRP), a common complication among patients with advanced malignant tumors, significantly impacts the health-related quality of life (HRQOL) for these patients. There is still a lack of multi-center large-scale randomized clinical trials investigating the efficacy of acupuncture therapy, particularly transcutaneous electrical acupoint stimulation (TEAS), in enhancing the health-related quality of life (HRQOL) among patients suffering from cancer-related pain. Objective To assess the effects of TEAS on HRQOL in cancer pain patients. Aimed to examine the correlation between cancer pain and HRQOL, and investigate the particular aspects in which TEAS enhances HRQOL. Methods A secondary analysis of HRQOL outcomes was conducted based on results from a randomized controlled trial involving 160 CRP patients undergoing chronic opioid therapy (No.ChiCTR-TRC-13003803, 2013/08/27, URL: https://www.chictr.org.cn/showproj.html?proj=5759 , with ethical protocol approved). The parent trial was carried out between 2014 and 2018 and compared the efficacy of a 3-week TEAS intervention applied to Jiaji (EX-B2) and limb analgesic acupoints versus sham-TEAS. In this secondary analysis, the primary outcome was the mean change in KPS value from baseline to Week 3. Secondary outcomes included the KPS value and EQ-5D-3L scores at week 3, 4 and 5, and BPI-I scores after TEAS intervention. Results True-TEAS suggested greater differences in the mean change of KPS value than sham-TEAS ( P < 0.05 at each timepoint), though the magnitude of change did not meet the minimum clinically important difference (MCID) threshold. The 3-week change were not significantly correlated with cancer type, sex, age, height or weight (-0.19, P > 0.05). At week 3, reduced pain scores were associated with greater mean changes in KPS (Spearman's r = -0.17, P < 0.05), especially in walking, working, mood, and sleep (all P < 0.05 in BPI-I). At week 5, true-TEAS patients reported fewer mobility, pain/discomfort, and anxiety/depression (all P < 0.05 in EQ-5D-3L). Conclusion This secondary analysis indicates that TEAS therapy may yield statistically significant improvements in HRQOL in CRP patients, observed at weeks 3, 4, and 5. These improvements may be related to enhanced physical capability and mood status driven by greater analgesic effects, though the magnitude of change did not meet the MCID threshold.