Effects of Adjunctive Electroacupuncture on Chemotherapy-Induced Nausea and Vomiting and Quality of Life in Subjects With Gynecologic Malignancies: A Retrospective Cohort Study

Objective To evaluate the association of adjunctive electroacupuncture (EA) with chemotherapy-induced nausea and vomiting (CINV) and quality of life in subjects with gynecologic malignancies. Methods Clinical data were retrospectively collected from 168 subjects with gynecologic malignancies who received chemotherapy from June 2022 to June 2025. Subjects were assigned to two groups according to whether adjunctive EA was used. The control group received guideline-based conventional antiemetic therapy, whereas the EA group received EA in addition to conventional antiemetic therapy. The complete response rate for CINV, use of rescue antiemetics, serotonin (5-HT), substance P (SP), dopamine (DA), hemoglobin (Hb), white blood cell count (WBC), serum creatinine (Scr), Functional Living Index-Emesis (FLIE) score, Karnofsky Performance Status (KPS) score, short-form Piper Fatigue Scale (PFS) score, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) scores were compared across the two treatment cohorts. Chemotherapy/conventional antiemetic-related adverse events and EA-related adverse events were also assessed. Results The EA group had higher CINV complete response rates at 24–120 h and 0–120 h than the control group. During 0–120 h, the EA group had a lower rescue antiemetic use rate; among the 69 patients who actually used rescue antiemetics (41 in the control group and 28 in the EA group), the EA group also had fewer additional rescue doses after the first rescue dose and a longer time to first rescue antiemetic use (all p < .05). Repeated-measures analysis of variance showed notable main effects of time and group and notable time-by-group interactions for 5-HT, SP, and DA (all p < .05). In both groups, SP at 24 and 120 h after chemotherapy and 5-HT and DA at 24 h after chemotherapy were higher than prechemotherapy values ( p < .05). Compared with the control group, the EA group had lower SP at 24 and 120 h and lower 5-HT and DA at 24 h after chemotherapy ( p < .05). The temporal patterns of 5-HT, SP, and DA differed across the two treatment cohorts ( p < .05). Hb, WBC, and Scr did not differ across the two treatment cohorts before treatment ( p > .05). After treatment, Hb, WBC, and Scr declined in both groups relative to baseline measurements ( p < .05), with no notable between-group differences after treatment ( p > .05). Baseline FLIE, KPS, and PFS scores were comparable across the two treatment cohorts ( p > .05). After treatment, FLIE scores decreased in both groups, PFS scores increased in both groups, and KPS scores decreased in the control group ( p < .05). After treatment, the EA group had higher FLIE and KPS scores and lower PFS scores than the control group ( p < .05). Baseline EORTC QLQ-C30 scores were comparable across the two treatment cohorts ( p > .05). After treatment, global health status and functional domain scores increased in the EA group ( p < .05). Symptom scores for nausea and vomiting, appetite loss, insomnia, constipation, and diarrhea also increased in the EA group, but the magnitude of increase was smaller than that in the control group, suggesting less symptom deterioration. In the control group, global health status and functional domain scores decreased, whereas fatigue, nausea and vomiting, pain, appetite loss, insomnia, constipation, and diarrhea scores increased after treatment ( p < .05). Following intervention, participants receiving EA attained superior ratings for global health status and all functional subscales, alongside diminished scale values of fatigue, CINV, pain, anorexia, sleep disturbance, constipation and diarrhea relative to patients under standard antiemetic management ( p < .05). The incidence of chemotherapy/conventional antiemetic-related adverse events did not differ significantly between the two groups ( p > .05). Three mild EA-related adverse events occurred in the EA group, and no serious EA-related adverse events were observed. Conclusion Adjunctive EA for gynecologic malignancies was associated with a lower incidence of CINV, reduced use of rescue antiemetics, and better quality-of-life scores, potentially through modulation of 5-HT, SP, and DA.