A Randomized Controlled Trial of Acupuncture for the Management of Hot Flashes in Patients With Hormone Receptor-Positive Breast Cancer (ACU-HRBC-HF)

March 18, 2026 updated by: Shu Wang, Peking University People's Hospital

针刺治疗激素受体阳性乳腺癌患者潮热的随机对照试验研究，A Randomized Controlled Trial of Acupuncture for the Management of Hot Flashes in Patients With Hormone Receptor-Positive Breast Cancer

Hot flashes are among the most common and distressing adverse effects experienced by patients receiving endocrine therapy for hormone receptor-positive breast cancer. Hormone replacement therapy (HRT) and non-hormonal medications can alleviate symptoms but are limited by side effects and safety concerns, leading to poor adherence. Acupuncture, a traditional Chinese medical therapy involving percutaneous stimulation of specific acupoints, has shown potential to reduce the frequency and severity of hot flashes with minimal adverse events.

This randomized, parallel-controlled clinical trial aims to evaluate the efficacy and safety of acupuncture in managing hot flashes in postoperative breast cancer patients undergoing endocrine therapy. Sixty eligible patients with stage I-III hormone receptor-positive breast cancer will be randomly assigned in a 1:1 ratio to receive either true acupuncture or sham acupuncture, three times per week for eight weeks, followed by a 16-week follow-up period without acupuncture. Functional magnetic resonance imaging (fMRI) will be employed to explore neural mechanisms underlying acupuncture's effects, alongside assessments of hot flash frequency, quality of life (FACT-B+ES), sleep quality (PSQI), and serum biomarkers related to endocrine and neuropeptide regulation. The results are expected to provide evidence for the efficacy and central mechanisms of acupuncture in managing hot flashes in breast cancer patients.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Background Breast cancer is the most prevalent malignancy among women. Advances in multimodal therapy-including surgery, chemotherapy, radiotherapy, endocrine therapy, and targeted therapy-have significantly improved prognosis and survival. However, endocrine therapy frequently induces vasomotor symptoms such as hot flashes, which severely impair quality of life.

Although hormone replacement therapy (HRT) and non-hormonal pharmacologic agents (e.g., SSRIs, anticonvulsants) can alleviate hot flashes, their safety and tolerability remain major limitations. Therefore, there is an urgent clinical need for safe and effective complementary interventions. Acupuncture has been widely used for symptom management in cancer patients due to its convenience, affordability, and safety. Multiple randomized controlled trials (RCTs) have demonstrated its effectiveness in reducing hot flashes and improving quality of life, with few adverse effects.

Functional magnetic resonance imaging (fMRI) studies further indicate that acupuncture can modulate brain regions related to thermoregulation and endocrine function. However, standardized clinical protocols and neuroimaging-based mechanistic studies for tumor-related hot flashes are still limited.

Study Design

This study adopts a single-center, randomized, parallel-controlled design. A total of 60 eligible patients will be randomly allocated (1:1) into two groups:

Group A (Treatment group): Endocrine therapy + True acupuncture Group B (Control group): Endocrine therapy + Sham acupuncture Randomization will be conducted using SAS 9.4 software (SAS Institute, Cary, NC, USA) with a sealed-envelope method. Allocation will be concealed from researchers responsible for recruitment and treatment. The study duration includes 8 weeks of treatment and 16 weeks of follow-up.

Participants Eligible participants are female patients aged 18-75 years with stage I-III hormone receptor-positive breast cancer, currently undergoing endocrine therapy (e.g., selective estrogen receptor modulators, aromatase inhibitors, CDK4/6 inhibitors, with or without ovarian suppression). Participants must have experienced hot flashes for at least 4 weeks, with ≥14 episodes per week and a mean Hot Flash Composite Score (HFCS) of 3-4.

Other key inclusion criteria include ECOG performance status 0-1 and a life expectancy >6 months.

Exclusion criteria include evidence of metastasis, concurrent chemotherapy or radiotherapy, recent use of medications affecting hot flashes (SSRIs, anticonvulsants), unstable cardiac disease, seizure history, MRI contraindications, recent acupuncture for hot flashes, active infection, pregnancy/lactation, or psychiatric/neurological disorders.

Interventions Group A (True Acupuncture) Acupoints: Sanyinjiao (SP6), Taixi (KI3), Taichong (LR3), Zusanli (ST36) Frequency: 3 sessions per week, for 8 consecutive weeks (24 sessions total) Procedure: Needles inserted to a depth of 0.5 cun, electrical stimulation at 2 Hz, even reinforcing-reducing manipulation until "Deqi" sensation achieved; needles retained for 30 minutes.

Group B (Sham Acupuncture) Points: Non-meridian, non-acupoint sites located 0.5-1 cm lateral to true points Frequency: 3 sessions per week, for 8 consecutive weeks Procedure: Needles inserted superficially (0.2 cun) without manipulation or "Deqi" sensation; 2 Hz electrical stimulation applied for 30 minutes.

Both groups continue standard endocrine therapy throughout the trial.

Outcome Measures Primary Outcome fMRI-based neuroimaging analysis: Brain activation patterns and structural changes will be assessed at baseline, mid-treatment, post-treatment, and follow-up to identify neural correlates of acupuncture response.

Secondary Outcomes Hot Flash Diary (HFRDIS): Frequency, severity, and impact on daily life recorded weekly.

Quality of Life: Functional Assessment of Cancer Therapy-Breast plus Endocrine Symptoms (FACT-B+ES, version 4).

Sleep Quality: Pittsburgh Sleep Quality Index (PSQI). Safety Evaluation: Incidence and severity of adverse events during treatment. Exploratory Outcomes Serum biomarkers: Changes in reproductive and neuroendocrine markers, including FSH, LH, E2, P, T, PRL, 5-HT, and CGRP.

Follow-up All participants will be followed up for 16 weeks after completing acupuncture treatment. At the end of follow-up, participants will undergo fMRI scanning and complete the HFRDIS, FACT-B+ES, and PSQI questionnaires.

Safety Assessment Adverse events will be recorded daily throughout the treatment phase. Criteria for early withdrawal include severe adverse reactions, serious complications, physiologic intolerance, loss to follow-up, or patient withdrawal of consent.

Expected Outcomes This trial will evaluate the clinical efficacy and neural mechanisms of acupuncture in alleviating hot flashes among breast cancer patients undergoing endocrine therapy. The findings are expected to provide high-quality evidence supporting acupuncture as a safe, effective, and mechanism-based complementary therapy, and to guide the development of standardized acupuncture protocols for cancer-related vasomotor symptoms.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
60

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • China
      • Beijing, China, 100000
        • Peking University People's Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria Female patients aged 18 to 75 years. Histopathologically confirmed breast cancer, currently receiving endocrine therapy (e.g., selective estrogen receptor modulators and/or aromatase inhibitors, CDK4/6 inhibitors), with or without ovarian function suppression, for at least 4 weeks and ongoing at the time of enrollment.

Expected survival time > 6 months. Experiencing persistent hot flashes for at least 4 weeks, with a frequency of ≥14 episodes per week (≥2 per day) during the week prior to enrollment, and a Hot Flash Composite Score (HFCS) of 3-4.

Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1:

0: Fully active, able to carry on all pre-disease performance without restriction;

  1. Restricted in physically strenuous activity but ambulatory and able to carry out light work (e.g., housework, office work);
  2. Ambulatory and capable of all self-care but unable to carry out any work activities; up and about more than 50% of waking hours;
  3. Capable of only limited self-care; confined to bed or chair more than 50% of waking hours;
  4. Completely disabled; cannot carry on any self-care; totally confined to bed or chair;
  5. Dead. Willing and able to participate in the study and sign the informed consent form.

Exclusion Criteria Evidence of tumor metastasis, currently undergoing radiotherapy, chemotherapy, or having a planned surgery.

Use of selective serotonin reuptake inhibitors (SSRIs) and/or anticonvulsants or other pharmacologic agents for hot flash management within 4 weeks prior to study entry.

Unstable cardiac disease or myocardial infarction within 6 months prior to study initiation.

Recent initiation or modification of endocrine therapy within 1 week, or planned initiation or modification within 14 weeks.

History or risk of seizure of unclear etiology. Prior acupuncture treatment for hot flashes within 6 months before enrollment. Contraindications to MRI scanning. Pregnant or lactating women. Presence of uncontrolled active infection. Severe psychiatric disorders or family history of psychiatric or neurological diseases.

Withdrawal Criteria Failure to complete acupuncture treatment per protocol, making efficacy evaluation impossible.

Use of medications or treatments during the trial that may affect study outcomes.

Voluntary withdrawal from the study during treatment.

Discontinuation Criteria Serious adverse events, complications, or physiological changes during treatment that make continuation unsafe or impractical.

Loss to follow-up or death after enrollment. Participant's voluntary withdrawal at any stage of treatment.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Endocrine therapy + True acupuncture
Other: True Acupuncture
Acupoints: Sanyinjiao (SP6), Taixi (KI3), Taichong (LR3), Zusanli (ST36) Frequency: 3 sessions per week, for 8 consecutive weeks (24 sessions total) Procedure: Needles inserted to a depth of 0.5 cun, electrical stimulation at 2 Hz, even reinforcing-reducing manipulation until "Deqi" sensation achieved; needles retained for 30 minutes.
Other: Endocrine therapy + Sham acupuncture
Other: Sham Acupuncture
Points: Non-meridian, non-acupoint sites located 0.5-1 cm lateral to true points Frequency: 3 sessions per week, for 8 consecutive weeks Procedure: Needles inserted superficially (0.2 cun) without manipulation or "Deqi" sensation; 2 Hz electrical stimulation applied for 30 minutes.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Cranial fMRI Imaging Evaluation and Data Analysis
Time Frame: 4 months
Functional magnetic resonance imaging (fMRI) of the brain will be performed before, during, and after treatment, as well as at the end of follow-up, to assess changes in brain structural and functional imaging characteristics.
4 months

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Hot Flash Assessment
Time Frame: 4 months
Hot flash severity and interference with daily life will be evaluated using the Hot Flash Related Daily Interference Scale (HFRDIS). The frequency of hot flashes during the week prior to each follow-up visit will also be recorded and statistically compared between the two groups.
4 months
Quality of Life Assessment
Time Frame: 4 months
Quality of life will be measured using the Functional Assessment of Cancer Therapy-Breast plus Endocrine Subscale (FACT-B, Version 4). The total scores of all subdomains will be analyzed and compared between groups.
4 months
Sleep Quality
Time Frame: 4 months
Sleep quality will be evaluated using the Pittsburgh Sleep Quality Index (PSQI).
4 months

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Exploratory Outcome Measures
Time Frame: 4 months
Exploratory biomarkers will be assessed in peripheral blood samples, including gonadal hormones - follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P), testosterone (T), and prolactin (PRL) - as well as serotonin (5-HT) and calcitonin gene-related peptide (CGRP).
4 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Peking University People's Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
April 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
October 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 8, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 8, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 19, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 19, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 18, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • PekingUPH-LM2025

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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