Auricular point acupressure for chemotherapy-induced peripheral neuropathy: a randomized controlled trial

Chemotherapy-induced peripheral neuropathy (CIPN) is common and persistent, with limited management options. This trial primarily examines whether auricular point acupressure (APA) improved CIPN outcomes versus usual care; a secondary pragmatic aim compared in-person mobile support (mAPA) with virtual (vAPA) delivery.

Two hundred twenty-seven cancer survivors with CIPN were randomized to mAPA (n = 80), vAPA (n = 75), or usual care (n = 72). Both APA arms received the same 4-week auricular point protocol; mAPA received in-person seed placement, and vAPA received video instruction for self-placement, with one coaching session for both. Usual care was standard oncologic and supportive care with no study-delivered APA. Primary outcome was a ≥20% reduction from baseline in an individualized composite outcome (ICO); each participant's highest-rated symptom-by-location item at baseline. Secondary outcomes were neuropathy interference, functional status, and quality of life. Intention-to-treat analyses used generalized estimating equations with multiple imputation and delta-adjusted sensitivity analyses.