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Complementary acupuncture treatment and reduced risk of sudden sensorineural hearing loss in nasopharyngeal carcinoma patients: a retrospective, nested case–control study

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Abstract

Purpose

Hearing loss is a frequently observed comorbidity in patients with nasopharyngeal carcinoma (NPC). Accumulating evidence demonstrated that acupuncture can safely manage cancer and its treatment-related symptoms, but its effect in minimizing the likelihood of experiencing sudden sensorineural hearing loss (SSHL) has not been established. So this work aimed to determine the risk of SSHL among NPC persons with or without acupuncture use.

Methods

One population-level, nested case–control design within a cohort study is employed. Relevant information on persons aged 20–80 years who were afflicted with NPC between 2000 and 2010 was extracted from a nationwide health claims database. From them, we identified the cases who had the first SSHL diagnosis occurring after NPC, and all of them were randomly matched to two controls without SSHL. Conditional logistic regression was employed to calculate odds ratios (OR) and its respective 95% confidence intervals (CI) for incident SSHL in relation to acupuncture treatment.

Results

Eight hundred eleven SSHL cases were randomly matched to 1452 controls. Those receiving conventional care plus acupuncture use had a reduced adjusted OR of 0.39 (95% CI, 0.25–0.60) for SSHL. We further discovered that the longer usage of acupuncture remarkably correlated with reduction of SSHL risk in a dose-dependent manner.

Conclusions

Delineation of the benefit from integration of acupuncture into conventional care may be a reference in instituting more appropriate care for NPC subjects.

Implications for Cancer Survivors

Patients living with NPC may benefit from a timely integration of acupuncture into routine care to lessen SSHL risk.

Graphical Abstract

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Data availability

The data that support the findings of this study are available from Taiwan’s NHI Administration, which administers the NHIRD, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from Taiwan’s NHI Administration (https://eng.nhi.gov.tw/en/mp-2.html).

Abbreviations

BDNF:

Brain-derived neurotrophic factor

CCI:

Charlson–Deyo Comorbidity Index

CCRT:

Concomitant chemotherapy and radiotherapy

CI:

Confidence interval

CIR:

Catastrophic Illness Registry

ICD-9-CM:

International Classification of Diseases, Ninth Revision, Clinical Modification

IL-6:

Interleukin-6

NF-êB:

Nuclear factor kappa-light-chain-enhancer of activated B cells

NHI:

National Health Insurance

NHIRD:

National Health Insurance Research Database

NPC:

Nasopharyngeal carcinoma

OR:

Odds ratio

PI3K:

Phosphatidylinositol 3-kinase

RT:

Radiotherapy

SD:

Standard deviation

SSHL:

Sudden sensorineural hearing loss

TCM:

Traditional Chinese medicine

TNF-á:

Tumor necrosis factor-alpha

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Acknowledgements

This study uses data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health, and managed by the National Health Research Institutes, Taiwan.

Author information

Author notes

  1. Yu-Jen Shen, Hou-Hsun Liao, Hanoch Livneh and Miao-Chiu Lin contributed equally to this work.

Authors and Affiliations

  1. Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan

    Yu-Jen Shen & Hou-Hsun Liao

  2. Department of Chinese Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan

    Yu-Jen Shen

  3. Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan

    Hou-Hsun Liao

  4. Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan

    Hou-Hsun Liao & Tzung-Yi Tsai

  5. Rehabilitation Counseling Program, Portland State University, Portland, USA

    Hanoch Livneh

  6. Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan

    Miao-Chiu Lin

  7. Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan

    Ming-Chi Lu

  8. School of Medicine, Tzu Chi University, Hualien, Taiwan

    Ming-Chi Lu & Szu-Chin Li

  9. Division of Hematology and Oncology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan

    Szu-Chin Li

  10. Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Tzung-Yi Tsai

  11. Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan

    Tzung-Yi Tsai

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  1. Yu-Jen Shen
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Contributions

Shen YJ, Liao HH, Lin MC and Tsai TY were involved in the study design and drafted the manuscript. Livneh H and Tsai TY contributed to data analysis and revised the manuscript. Livneh H, Lin MC and Li SC contributed to the interpretation of data and provided comments on the final draft of the manuscript. Lu MC and Liao HH provided administrative support and comments on the manuscript drafts. All authors gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Corresponding authors

Correspondence to Szu-Chin Li or Tzung-Yi Tsai.

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Shen, YJ., Liao, HH., Livneh, H. et al. Complementary acupuncture treatment and reduced risk of sudden sensorineural hearing loss in nasopharyngeal carcinoma patients: a retrospective, nested case–control study. J Cancer Surviv (2024). https://doi.org/10.1007/s11764-024-01552-z

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