CAM בגידולים מתקדמים: חסר תועלת

J Clin Oncol. 2007 Feb 10;25(5):548-54. Complementary AND alternative medicine among advanced cancer patients enrolled on phase I trials: a study of prognosis, quality of life, AND preferences for decision making. PURPOSE: We sought to describe complementary AND alternative medicine (CAM) usage among phase I trial participants AND to describe these patients' treatment decision-making preferences, awareness of prognosis, survival, AND quality of life. PATIENTS AND METHODS: Advanced cancer patients enrolling onto phase I trials were surveyed regarding biologically based CAM use. Decision-making preferences AND awareness of prognosis were assessed using validated and/or standardized instruments. The Functional Assessment of Cancer Therapy-General instrument was used to assess quality of life. Univariate AND multivariate analyses were performed to detect differences between CAM users AND nonusers. RESULTS: Of 212 interviewed patients, 34% (n = 72) described taking biologically based CAM. Median age of those taking biologically based CAM was 55 years, compared with 62 years for nonusers (P < .005). There were no statistically significant differences found between CAM usage AND preferences for degree of patient involvement in medical decision making. Those patients who acknowledged that their deaths were likely to occur within 1 year were more likely to admit to prior CAM use (70% v 34%; P = .02). CAM users had poorer overall quality of life compared with nonusers (87.0 +/- 12.4 v 91.2 +/- 14.7; P = .007). No differences in survival were identified. CONCLUSION: Prior CAM use among phase I cancer trial patients studied was common AND associated with age, stated acknowledgment of prognosis, AND quality of life. Patients enrolling onto early-phase trials should be questioned about CAM use. Additional study is needed to determine the frequency of use of those biologically based CAM agents that threaten the accuracy of early-phase cancer trial data.

לא כתוב האם המחקר בוצע על חלים שעברו לפני כן ניתוחים, הקרנות וכימותרפיה. לא כתוב איזה טיפולים טבעיים הם קיבלו. אנשים במצב מחלה מתקדם כנראה עברו לפני כן את הוויה דולורוזה של הניתוחים ההקרנות והכימותרפיה ולכן סיכויי ההישרדות שלהם היו נמוכים מאוד. האם הם שינו את אורח החיי שלהם? האם עברו לתזונה צמחונית אורגנית? איזה תוספים הם קבלו?

Cochrane Database Syst Rev. 2007 Jan 24 Medicinal herbs for esophageal cancer BACKGROUND: Esophageal cancer is the seventh leading cause of cancer death worldwide. Traditional Chinese medicinal herbs are sometimes used as an adjunct to radiotherapy OR chemotherapy for this type of cancer. OBJECTIVES: To assess the efficacy AND possible adverse effects of the addition of Chinese medicinal herbs to treatment with radiotherapy OR chemotherapy for esophageal cancer. SEARCH STRATEGY: We searched the Cochrane Upper Gastrointestinal AND Pancreatic Diseases Group Trials Register, The Cochrane Library, MEDLINE, EMBASE, AMED (Allied AND Complementary Medicine Database), CBM (Chinese Biomedical Database), China National Knowledge Infrastructure, the Chinese Cochrane Centre Controlled Trials Register AND CISCOM (The Research Council for Complementary Medicine) (up to June 2004). Databases of ongoing trials, the internet AND reference lists were also searched. SELECTION CRITERIA: Randomised controlled trials comparing the use of radiotherapy OR chemotherapy with AND without the addition of Chinese medicinal herbs. DATA COLLECTION AND ANALYSIS: At least two review authors extracted data AND assessed trial quality. MAIN RESULTS: Two studies were included. The numbers of participants in these two trials were 42 AND 80, 122 in total. Both studies were analysed separately because of the differences in interventions used. Although one study reported a positive result, the majority of outcome measurements from the two studies showed no significant benefit with the addition of Chinese herbal medicines to radiotherapy OR chemotherapy. There was statistically significant improvement in quality of life with the additional Huachansu injection, however, no statistically significant improvement was found in short-term therapy effects, one-year survival rate OR the adverse effect of radiation-induced esophagitis. AUTHORS' CONCLUSIONS: The included studies were of low quality. The results suggest Zhenxiang capsules OR Huachansu injection may not improve short-term therapy effects OR one-year survival rate when used as adjunct treatment to chemo- OR radiotherapy in the treatment of esophageal cancer. The quality of life may be improved by Huachansu injection. The results suggest that more high-quality trials on Huachansu injection AND other Chinese herbal medicines are needed in the future