אונקולוגיה
שילוב של צמחי מרפא סיניים עם כימותרפיה שיפר באופן מובהק הישרדות של שנה אח בחולי סרטן ריאות
( מסוג NSCLC)
קישור למחקר:
שם המחקר:
: PLoS One. 2013;8(2):e57604. doi: 10.1371/journal.pone.0057604. Epub 2013 Feb 28.
The efficacy of Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer: a systematic review and meta-analysis.
Li SG1, Chen HY, Ou-Yang CS, Wang XX, Yang ZJ, Tong Y, Cho WC.
תקציר
Abstract
Many published studies reflect the growing application of complementary and alternative medicine, particularly Chinese herbal medicine (CHM) use in combination with conventional cancer therapy for advanced non-small cell lung cancer (NSCLC), but its efficacy remains largely unexplored. The purpose of this study is to evaluate the efficacy of CHM combined with conventional chemotherapy (CT) in the treatment of advanced NSCLC. Publications in 11 electronic databases were extensively searched, and 24 trials were included for analysis. A sum of 2,109 patients was enrolled in these studies, at which 1,064 patients participated in CT combined CHM and 1,039 in CT (six patients dropped out and were not reported the group enrolled). Compared to using CT alone, CHM combined with CT significantly increase one-year survival rate (RR = 1.36, 95% CI = 1.15-1.60, p = 0.0003). Besides, the combined therapy significantly increased immediate tumor response (RR = 1.36, 95% CI = 1.19-1.56, p<1.0E-5) and improved Karnofsky performance score (KPS) (RR = 2.90, 95% CI = 1.62-5.18, p = 0.0003). Combined therapy remarkably reduced the nausea and vomiting at toxicity grade of III-IV (RR = 0.24, 95% CI = 0.12-0.50, p = 0.0001) and prevented the decline of hemoglobin and platelet in patients under CT at toxicity grade of I-IV (RR = 0.64, 95% CI = 0.51-0.80, p<0.0001). Moreover, the herbs that are frequently used in NSCLC patients were identified. This systematic review suggests that CHM as an adjuvant therapy can reduce CT toxicity, prolong survival rate, enhance immediate tumor response, and improve KPS in advanced NSCLC patients. However, due to the lack of large-scale randomized clinical trials in the included studies, further larger scale trials are needed.
מטופלים אונקולוגיים מדווחים על התלבטות וחרדה בבואם לבחור בטיפולי רפואה משלימה ואינטגרטיבית. עבודה זו מסייעת לתהליך ההחלטה והבחירה.
http://www.ncbi.nlm.nih.gov/pubmed/25009685
Open Med. 2014 Apr 15;8(2):e54-66. eCollection 2014.
Decision-making about complementary and alternative medicine by cancer patients: integrative literature review.
Weeks L1, Balneaves LG2, Paterson C3, Verhoef M4.
Abstract
BACKGROUND:
Patients with cancer consistently report conflict and anxiety when making decisions about complementary and alternative medicine (CAM) treatment. To design evidence-informed decision-support strategies, a better understanding is needed of how the decision-making process unfolds for these patients during their experience with cancer. We undertook this study to review the research literature regarding CAM-related decision-making by patients with cancer within the context of treatment, survivorship, and palliation. We also aimed to summarize emergent concepts within a preliminary conceptual framework.
METHODS:
We conducted an integrative literature review, searching 12 electronic databases for articles published in English that described studies of the process, context, or outcomes of CAM-related decision-making. We summarized descriptive data using frequencies and used a descriptive constant comparative method to analyze statements about original qualitative results, with the goal of identifying distinct concepts pertaining to CAM-related decision-making by patients with cancer and the relationships among these concepts.
RESULTS:
Of 425 articles initially identified, 35 met our inclusion criteria. Seven unique concepts related to CAM and cancer decision-making emerged: decision-making phases, information-seeking and evaluation, decision-making roles, beliefs, contextual factors, decision-making outcomes, and the relationship between CAM and conventional medical decision-making. CAM decision-making begins with the diagnosis of cancer and encompasses 3 distinct phases (early, mid, and late), each marked by unique aims for CAM treatment and distinct patterns of information-seeking and evaluation. Phase transitions correspond to changes in health status or other milestones within the cancer trajectory. An emergent conceptual framework illustrating relationships among the 7 central concepts is presented.
INTERPRETATION:
CAM-related decision-making by patients with cancer occurs as a nonlinear, complex, dynamic process. The conceptual framework presented here identifies influential factors within that process, as well as patients' unique needs during different phases. The framework can guide the development and evaluation of theory-based decision-support programs that are responsive to patients' beliefs and preferences.
לנוכח עליית השימוש ברפואה משלימה ואינטגרטיבית בקרב חולי סרטן וביסוס גוף הידע התומך בשימוש- עבודה זו מכוונת אחיות אונקולוגיה ללמוד נושא זה
http://www.ncbi.nlm.nih.gov/pubmed/22281306
Semin Oncol Nurs. 2012 Feb;28(1):2-9. doi: 10.1016/j.soncn.2011.11.002.
Integrative oncology imperative for nurses.
Abstract
OBJECTIVES:
To provide an overview of key issues and resources related to complementary and alternative medical (CAM) and integrative approaches in cancer care.
DATA SOURCES:
Peer-reviewed publications and web sites of professional, federal, and academic institutions and organizations.
CONCLUSION:
The field of integrative oncology is growing and research evidence in this area is burgeoning. Many cancer patients are using and can benefit from CAM. There are many resources and educational opportunities available to oncology nurses to enhance their CAM knowledge and skills.
IMPLICATIONS FOR NURSING PRACTICE:
Nurses must keep abreast of the growing evidence in integrative oncology that documents the safety and efficacy of different CAM approaches for cancer patients. It is critical that nurses be aware of reputable resources and legal implications related to use of CAM.