Background: A natural-killer (NK) cell is a cytotoxic lymphocyte that responds to tumor formation. Electroacupuncture (EA) in patients with cancer, who had chemotherapy, enabled them to maintain their T-cell counts (CD3+, CD4+, and CD8+) and NK-cell activity. Objective: To evaluate NK-cell levels and tumor sizes in patients with cervical squamous-cell carcinoma (SCC) after EA on ST 36 (Zusanli). Design: This study was a randomized, experimental clinical study with a pre-post-test, control group design. Setting The study was performed in the obstetrics and gynecology department, Gynecology Oncology Division of the Rumah Sakit Dokter Soetomo General Hospital, in Surabaya, Jawa Timur, Indonesia, conducted from February 2016 until May 2016. Subjects: Patients with cervical SCC, stages IIb-IIIb (locally advanced)-determined clinically and histopathologically-all of whom had 50 mg/m2/week of cisplatin chemotherapy. The patients were divided, consecutively, into 2 groups by simple random sampling. Intervention: The controls received only received the chemotherapy, while treatment-group patients also had EA 1 day on bilateral ST 36 after each chemotherapy cycle. Outcome Measures: Primary outcomes were percent of NK cells and tumor size. Before the first treatment and after the fourth one, all patients underwent peripheral blood examinations (complete blood counts, serum creatinine and blood-urea-nitrogen levels, and flow-cytometry) to determine percentages of NK cells, and pelvic magnetic resonance imaging to measure cervical tumor sizes. Secondary outcomes were pain, nausea, vomiting, and appetite. Results: There was a significant increase in number of NK cells (P = 0.00) and a significant decrease in tumor sizes (P = 0.03) in the treatment group, compared to the control group. There was a significant increase in appetite (P = 0.00) in the treatment group, compared to baseline, but there were no significant differences in pain (P = 0.061), nausea (P = 0.399), and vomiting (P = 0.854). Conclusions: Patients with cervical SCC at stages IIb-IIIb, who received 4 cycles of chemotherapy using 50 mg/m2/week of cisplatin and EA at ST 36, had increased NK-cell percentages in their peripheral blood and had reductions in their cervical tumors.
Keywords: cervical squamous-cell carcinoma; electroacupuncture; natural-killer cells.