Richardson M A, Russell N C, Sanders T, Barrett R, Salveson C
University of Texas--Center for Alternative Medicine Research, The University of Texas--Houston Health Science Center School of Public Health, USA.
J Altern Complement Med. 2001 Feb;7(1):19-32. doi: 10.1089/107555301300004501.
This pilot study tested the feasibility of performing outcomes and more advanced research regarding cancer patients at two complementary and alternative (CAM) clinics. The primary objectives were to determine the feasibility of (1) obtaining and collecting data from medical records, (2) determining 5-year survival, and (3) comparing 5-year survival to that of conventional treatment. In addition, in this paper we present the barriers and recommend strategies to facilitate high-quality research.
SETTINGS/LOCATION: The Bio-Medical Center in Tijuana, Mexico, and the Livingston Foundation Medical Center in San Diego, California.
New patients who were treated for cancer during 1992 at the Livingston Foundation Medical Center and during the first quarter of 1992 at the Bio-Medical Center.
Charts were available for 89.6% of the 307 new patients treated at the Bio-Medical Center; 149 (54%) patients were treated for cancer and 65 (43.6%) cases were confirmed by pathology reports. In contrast, all records were available for 193 new patients treated for cancer at the Livingston Clinic; 152 (78.8%) cases had pathology confirmation. At both clinics, patients were equally divided by gender and were predominantly Caucasian, were married, and were U.S. residents. On average, patients were 51-54 years old and within 1 year of diagnosis for breast, colorectal, lung, or male genital cancer. Most patients (61.1%-63.7%) arrived with distant or regional disease after conventional surgery and/or chemotherapy/radiotherapy. Survival at 5 years was determined for 57.0% at the Bio-Medical Center (11.4% were alive and 45.6% were deceased) and 94.8% at Livingston (14.5% were alive and 80.3% were deceased). The limited number of cases by cancer site prevented comparison to conventional treatment.
Historical, widespread use of clinics such as these with anecdotal reports of extraordinary survival merit prospective, systematic monitoring of patient outcomes. For data to be meaningful, however, disease status must be pathologically confirmed and patient follow-up improved.
这项初步研究检验了在两家补充替代医学（CAM）诊所对癌症患者进行结局评估及更深入研究的可行性。主要目标是确定以下方面的可行性：（1）从病历中获取和收集数据；（2）确定5年生存率；（3）将5年生存率与传统治疗的生存率进行比较。此外，本文还阐述了障碍并推荐了促进高质量研究的策略。
墨西哥蒂华纳的生物医学中心和加利福尼亚州圣地亚哥的利文斯顿基金会医疗中心。
1992年在利文斯顿基金会医疗中心以及1992年第一季度在生物医学中心接受癌症治疗的新患者。
在生物医学中心接受治疗的307名新患者中，89.6%的病历可用；149名（54%）患者接受了癌症治疗，65例（43.6%）经病理报告确诊。相比之下，利文斯顿诊所193名接受癌症治疗的新患者的所有记录均可用；152例（78.8%）病例有病理确诊。在两家诊所，患者按性别平均分配，主要为白种人，已婚，且是美国居民。平均而言，患者年龄在51 - 54岁之间，患有乳腺癌、结直肠癌、肺癌或男性生殖系统癌症且确诊时间在1年内。大多数患者（61.1% - 63.7%）在接受传统手术和/或化疗/放疗后出现远处或局部疾病。生物医学中心5年生存率为57.0%（11.4%存活，45.6%死亡），利文斯顿诊所为94.8%（14.5%存活，80.3%死亡）。由于癌症部位的病例数量有限，无法与传统治疗进行比较。
长期以来，这类诊所被广泛使用，且有关于其非凡生存率的传闻报道，因此有必要对患者结局进行前瞻性、系统性监测。然而，要使数据有意义，疾病状态必须经病理确认且患者随访情况需得到改善。
