Electroacupuncture in Treating Delayed Nausea and Vomiting in Patients Receiving Chemotherapy For Newly Diagnosed Childhood Sarcoma, Neuroblastoma, Nasopharyngeal Cancer, Germ Cell Tumors, or Hodgkin Lymphoma

OBJECTIVES:

Primary

- Determine the efficacy of electroacupuncture, in terms of reducing acute and delayed
chemotherapy-induced nausea, in patients with newly diagnosed pediatric sarcoma,
neuroblastoma, nasopharyngeal carcinoma, or germ cell tumors.

Secondary

- Determine the efficacy of this therapy, in terms of reducing delayed
chemotherapy-induced emesis, in these patients.

- Determine the efficacy of this therapy, in terms of altering salivary cortisol levels
and fasting serum glucose and insulin levels as stress parameters, in these patients.

- Determine the efficacy of this therapy, in terms of improving the quality of life, in
these patients.

- Determine the efficacy of this therapy, in terms of reducing acute nausea and emesis,
in these patients.

OUTLINE: This is a multicenter, randomized, double-blind study. Patients are stratified
according to planned treatment with cisplatin-based chemotherapy (yes vs no) and gender.
Patients are randomized to 1 of 2 arms.

- Arm I: Patients undergo electroacupuncture to specific acupuncture points on the arms
and legs over 25 minutes twice daily on days 1 and 2 and then once daily on days 3-7
during week 1 of chemotherapy course 1 (9 acupuncture treatments total).

- Arm II: Patients undergo electroacupuncture to sham points on the arms and legs as in
arm I.

Quality of life is assessed at baseline, on days 1 and 8 of each treatment course, and then
after completion of the study.

PROJECTED ACCRUAL: A total of 65 patients (approximately 32 per arm) will be accrued for
this study within 2.5-3 years.

DISEASE CHARACTERISTICS:

- Newly diagnosed malignancy of 1 of the following types:

- Pediatric sarcoma

- Neuroblastoma

- Nasopharyngeal carcinoma

- Germ cell tumor

- Hodgkin lymphoma

- Meets 1 of the following criteria:

- Eligible for Children's Oncology Group (COG) protocol for sarcoma,
neuroblastoma, or germ cell tumor

- Eligible for NCI Pediatric Oncology Branch (POB) protocol for sarcoma

- Following COG-approved standard treatment regimen for sarcoma, neuroblastoma,
nasopharyngeal carcinoma, or germ cell tumor

- Enrolled on the POB natural history protocol 98-C-0037

- Planned treatment, according to COG or POB protocols, that includes a cisplatin-
and/or doxorubicin-containing regimen for sarcoma, neuroblastoma, nasopharyngeal
carcinoma, germ cell tumor, or Hodgkin lymphoma OR either a
cyclophosphamide/ifosfamide-doxorubicin-containing or
cyclophosphamide/dactinomycin-containing regimen for rhabdomyosarcoma

- No clinical or radiographic signs of spinal cord compression

PATIENT CHARACTERISTICS:

Age:

- 5 to 35

Performance status:

- Not specified

Life expectancy:

- Not specified

Hematopoietic:

- Platelet count greater than 50,000/mm^3 (transfusion independent)

- No clotting disorders, including hemophilia

Hepatic:

- PT and PTT normal (within 10% of institution's upper limit of normal)

Renal:

- Not specified

Other:

- Not pregnant

- No casting of 1 or more extremities

- No other condition that would preclude access to acupuncture points

- No cognitive impairment

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Not specified

Chemotherapy:

- See Disease Characteristics

- No prior systemic chemotherapy

Endocrine therapy:

- More than 4 weeks since prior glucocorticoid therapy

- No concurrent glucocorticoid therapy

Radiotherapy:

- Not specified

Surgery:

- Not specified

Other:

- No prior acupuncture

- No concurrent anticoagulants