acupuncture or standard therapy in treating pain and dysfunction in patients who have undergone neck surgery for head and neck cancer

Conditions: Head and Neck Cancer; Pain

Summary: rationale: acupuncture may help relieve pain and dysfunction caused by cancer surgery. it is not yet known whether acupuncture is more effective than standard therapy in treating pain and dysfunction in patients who have undergone neck surgery for head and neck cancer. purpose: this randomized phase iii trial is studying acupuncture to see how well it works compared to standard therapy in treating pain and dysfunction in patients who have undergone neck surgery for head and neck cancer.

objectives: primary * determine whether acupuncture reduces pain and dysfunction in patients with head and neck cancer who have undergone neck dissection. secondary * determine whether acupuncture relieves dry mouth in these patients. outline: this is a randomized, controlled study. patients are stratified according to surgical procedure (selective neck dissection vs modified radical neck dissection vs radical neck dissection) and baseline constant-murley score (≤ 35 vs \> 35). patients are randomized into 1 of 2 treatment arms. * arm i: patients undergo acupuncture for 20-30 minutes once weekly for 4 weeks. * arm ii: patients undergo standard of care for 4 weeks. in both arms, treatment continues in the absence of unacceptable toxicity. the constant-murley score is assessed at baseline and then at week 6. pain medication use is recorded at baseline, during study treatment, and then at week 6. numerical rating scale of pain on activity and xerostomia inventories are completed at baseline and then at weeks 5 and 6. after completion of study treatment, patients are followed periodically. projected accrual: a total of 58 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * must have undergone neck dissection for cancer ≥ 3 months ago (in order to qualify pain as chronic sequella) * subjective complaint of pain and/or dysfunction in the neck and/or shoulders that, in the opinion of the investigator, is due to neck dissection * constant-murley score ≤ 70 (i.e., moderate or severe pain and dysfunction) * no moderate or severe neck or shoulder pain that, in the opinion of the investigator, is not due to cancer surgery patient characteristics: * not specified prior concurrent therapy: * see disease characteristics * at least 3 months since prior radiotherapy * more than 6 weeks since prior acupuncture * concurrent analgesics allowed

Keywords: pain recurrent squamous cell carcinoma of the hypopharynx stage i squamous cell carcinoma of the hypopharynx stage ii squamous cell carcinoma of the hypopharynx stage iii squamous cell carcinoma of the hypopharynx stage iv squamous cell carcinoma of the hypopharynx recurrent squamous cell carcinoma of the larynx recurrent verrucous carcinoma of the larynx stage i squamous cell carcinoma of the larynx stage i verrucous carcinoma of the larynx stage ii squamous cell carcinoma of the larynx stage ii verrucous carcinoma of the larynx stage iii squamous cell carcinoma of the larynx stage iii verrucous carcinoma of the larynx stage iv squamous cell carcinoma of the larynx stage iv verrucous carcinoma of the larynx recurrent squamous cell carcinoma of the lip and oral cavity stage i squamous cell carcinoma of the lip and oral cavity stage ii squamous cell carcinoma of the lip and oral cavity stage iii squamous cell carcinoma of the lip and oral cavity stage iv squamous cell carcinoma of the lip and oral cavity recurrent basal cell carcinoma of the lip stage i basal cell carcinoma of the lip stage ii basal cell carcinoma of the lip stage iii basal cell carcinoma of the lip stage iv basal cell carcinoma of the lip recurrent adenoid cystic carcinoma of the oral cavity recurrent mucoepidermoid carcinoma of the oral cavity recurrent verrucous carcinoma of the oral cavity stage i adenoid cystic carcinoma of the oral cavity stage i mucoepidermoid carcinoma of the oral cavity stage i verrucous carcinoma of the oral cavity stage ii adenoid cystic carcinoma of the oral cavity stage ii mucoepidermoid carcinoma of the oral cavity stage ii verrucous carcinoma of the oral cavity stage iii adenoid cystic carcinoma of the oral cavity stage iii mucoepidermoid carcinoma of the oral cavity stage iii verrucous carcinoma of the oral cavity stage iv adenoid cystic carcinoma of the oral cavity stage iv mucoepidermoid carcinoma of the oral cavity stage iv verrucous carcinoma of the oral cavity metastatic squamous neck cancer with occult primary squamous cell carcinoma recurrent metastatic squamous neck cancer with occult primary recurrent lymphoepithelioma of the nasopharynx recurrent squamous cell carcinoma of the nasopharynx stage i lymphoepithelioma of the nasopharynx stage i squamous cell carcinoma of the nasopharynx stage ii lymphoepithelioma of the nasopharynx stage ii squamous cell carcinoma of the nasopharynx stage iii lymphoepithelioma of the nasopharynx stage iii squamous cell carcinoma of the nasopharynx stage iv lymphoepithelioma of the nasopharynx stage iv squamous cell carcinoma of the nasopharynx recurrent lymphoepithelioma of the oropharynx recurrent squamous cell carcinoma of the oropharynx stage i lymphoepithelioma of the oropharynx stage i squamous cell carcinoma of the oropharynx stage ii lymphoepithelioma of the oropharynx stage ii squamous cell carcinoma of the oropharynx stage iii lymphoepithelioma of the oropharynx stage iii squamous cell carcinoma of the oropharynx stage iv lymphoepithelioma of the oropharynx stage iv squamous cell carcinoma of the oropharynx recurrent esthesioneuroblastoma of the paranasal sinus and nasal cavity recurrent inverted papilloma of the paranasal sinus and nasal cavity recurrent midline lethal granuloma of the paranasal sinus and nasal cavity recurrent squamous cell carcinoma of the paranasal sinus and nasal cavity stage i esthesioneuroblastoma of the paranasal sinus and nasal cavity stage i inverted papilloma of the paranasal sinus and nasal cavity stage i midline lethal granuloma of the paranasal sinus and nasal cavity stage i squamous cell carcinoma of the paranasal sinus and nasal cavity stage ii esthesioneuroblastoma of the paranasal sinus and nasal cavity stage ii inverted papilloma of the paranasal sinus and nasal cavity stage ii midline lethal granuloma of the paranasal sinus and nasal cavity stage ii squamous cell carcinoma of the paranasal sinus and nasal cavity stage iii esthesioneuroblastoma of the paranasal sinus and nasal cavity stage iii inverted papilloma of the paranasal sinus and nasal cavity stage iii midline lethal granuloma of the paranasal sinus and nasal cavity stage iii squamous cell carcinoma of the paranasal sinus and nasal cavity stage iv esthesioneuroblastoma of the paranasal sinus and nasal cavity stage iv inverted papilloma of the paranasal sinus and nasal cavity stage iv midline lethal granuloma of the paranasal sinus and nasal cavity stage iv squamous cell carcinoma of the paranasal sinus and nasal cavity recurrent salivary gland cancer stage i salivary gland cancer stage ii salivary gland cancer stage iii salivary gland cancer stage iv salivary gland cancer