This study aims to objectively evaluate the effect of Patient-Controlled Transcutaneous Electrical Acupoint Stimulation (PC-TEAS) on improving the quality of life in patients with chronic cancer pain, thereby providing evidence-based medical support for its efficacy and offering practical basis for patients to achieve home-based auxiliary treatment based on their own needs. Furthermore, by observing and comparing changes in indicators such as pain-related scores, analgesic consumption, emotional scores, spontaneous bowel movements, and adverse events, this research will comprehensively assess the advantages of PC-TEAS in the management of chronic cancer pain and explore other potential benefits of this intervention for patients.
Age between 18 and 80 years, regardless of gender;
Diagnosis of primary or metastatic malignant tumor confirmed by histopathology and/or cytology, consistent with the American Cancer Society criteria for malignancy;
Presence of cancer-related pain, defined as an average Numeric Rating Scale (NRS) score ≥ 2 over the preceding week or current regular use of opioid analgesics;
Life expectancy ≥ 3 months;
Pain not attributable to cancer;
Severe cardiopulmonary dysfunction or respiratory depression;
Implantation of cardiac pacemaker or metallic implants at stimulation sites;
Local skin lesions or conditions unsuitable for TEAS at the acupoint sites;
Parallel
TEAS
Other interventionPatients assumed a supine or sitting position, and after routine skin disinfection at the acupoint sites, one pair of electrode patches was attached to the two ipsilateral acupoints of the same group, with the same procedure performed on the contralateral side. A transcutaneous electrical acupoint stimulator was used to apply TEAS sequentially to acupoint groups ① and ②. Each acupoint group received a single TEAS session lasting 30 minutes. Participants were permitted to undergo multiple TEAS sessions within the same day, with all treatments recorded in a pain diary. The TEAS parameters were set as a continuous wave at a frequency of 2 Hz, with the current intensity adjusted to the patient's tolerance level. The treatment followed a "patient-controlled, as-needed" administration pattern. Each treatment course lasted 7 days, with a minimum of 3 treatment days per course and a total of no fewer than 5 sessions per course. A total of 4 treatment courses were conducted.
sham TEAS
Other interventionParticipants were informed that, due to individual variations in sensory thresholds, it is normal if no distinct sensation is perceived even at the maximum stimulation intensity. Regardless of subjective perception, the transcutaneous electrical acupoint stimulation treatment remains active and exerts its therapeutic effects continuously.
The area under the curve (AUC) of the FACT-G (Functional Assessment of Cancer Therapy - General) total score for assessing quality of life in patients with chronic cancer pain after 4 weeks of treatment.
the FACT-G comprises 27 items grouped into 4 domains: physical well-being, social/family well-being, emotional well-being, and functional well-being; some items require reverse scoring, with the total score ranging from 0 to 108. Higher scores indicate better quality of life. Using the area under the curve scoring method allows for the observation of the cumulative benefit of PC-TEAS usage in patients over the entire treatment period
the changes in BPI score from baesline
The Brief Pain Inventory (BPI) is primarily used to assess pain severity and its multidimensional impact on patients' quality of life. The scale consists of two core components: BPI-S (Pain Severity) and BPI-I (Pain Interference). The BPI-S quantifies the severity of pain through four items: average pain, worst pain, least pain, and current pain intensity. The BPI-I evaluates the degree to which pain interferes with daily functioning across seven domains: mobility, activities of daily living, work, sleep, relationships with others, enjoyment of life, and mood, thereby providing a comprehensive multidimensional reflection of pain's impact on patient quality of life.Scores range from 0-10, with higher scores indicating more severe pain
Dosage of analgesics used on the assessment days
Changes in the amount of analgesic use from baseline
Spontaneous bowel movements (SBM) during assessment days
Spontaneous bowel movements (SBM) refer to bowel movements that occurred in the past 24 hours without the use of rescue laxatives. The number of spontaneous bowel movements by the subjects in the past week was recorded.
Bowel Function Index (BFI) during assessment days
The Bowel Function Index (BFI) is a clinical tool specifically designed to assess opioid-induced constipation. It records the patient's ratings over the past week for straining during defecation, sense of incomplete bowel evacuation, and overall satisfaction with the bowel movement process.
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