Effects and Mechanisms of Massotherapy of Acupoints, Gene Polymorphisms of RRM1 and RRM2 on Relieving Chemotherapy-Induced Myelossupression among Patients with Cervical Cancer

The application of chemotherapy is used for treatment of patients with stage IVb or recurrent cervical cancer, however, chemotherapy-induced myelossupression is significant, it can lead to a dose reduction of chemotherapy agents, delayed treatment, and decreased survival rate. National insurance limits the application of granulocyte-colony stimulating factors (G-CSF) for alleviating myelossupression in Taiwan. The development of nursing intervention for alleviating myelossupression among cervical cancer patients is recommend. The purpose of this three-year study is to investigate the effects and mechanisms of massotherapy of acupoints, gene polymorphisms of RRM1 and RRM2 on relieving chemotherapy-induced myelossupression among patients with cervical cancer. A crossover randomized intervention study followed by a standardized massotherapy protocol will be conducted. Patients received active massotherapy of acupoints including LI4, LI11, SP10, LR3, K3, SP6, ST36, and GV20 versus sham massotherapy while undergoing chemotherapy. The blood counts including white blood cell, neutrophil, eosinophil, basophil, monocyte, lymphocyte, red blood cell, hemoglobin, hematocrit, platelet, bleeding time, and coagulating time for estimating the effect on alleviation of myelossupression as well as cytokines including SCF, GM-CSF, IL-1, IL-2, IL-3, IL-6, IL-8, IL-12, TGF-B, IFN-r, and TNF-for investigating the mechanism before and after massotherapy of acupoint will be conducted. In order to application of this study on nursing care and self care. In this proposed project, we will 【 1 】 estimate the effect of massotherapy of acupoints on alleviating chemotherapy-induced myelossupression. 【2】estimate the effect of massotherapy between nurse achievement group and patient achievement group.【3】estimate time-dependent effect of massotherapy on alleviating chemotherapy-induced myelossupression. 【4】estimate the relationship between cytokine expression and massotherapy of acupoint. 【5】estimate time-dependent effect of massotherapy on cytokine expression.【6】estimate the relationship between RRM1 and RRM2 gene polymorphisms and the effect of massotherapy on alleviating chemotherapy-induced myelossupression.