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[在一项关于用槲寄生治疗乳腺癌患者的研究中所展现出的补充医学随机研究的问题]

[Problems of randomized studies in complementary medicine demonstrated in a study on mistletoe treatment of patients with breast cancer].

作者信息

Gerhard I, Abel U, Loewe-Mesch A, Huppmann S, Kuehn J J

机构信息

Ambulanz für Naturheilkunde, Universitäts-Frauenklinik, Heidelberg, Germany.

出版信息

Forsch Komplementarmed Klass Naturheilkd. 2004 Jun;11(3):150-7. doi: 10.1159/000079444.

Abstract

BACKGROUND

Prospective randomized studies on mistletoe therapy repeatedly demonstrated that there is a basic problem in the matter of enrolling the appropriate number of patients within a reasonable amount of time. Most studies have to face this problem. However, recent experience suggests that this problem is more pronounced in the case of mistletoe treatment of cancer patients.

OBJECTIVE

Possibility of recruitment and randomization of breast cancer patients for a mistletoe study.

PATIENTS

During a period of 28 months every patient was registered who was admitted to the Gynecological Hospital of the University of Heidelberg because of suspected cancer.

RESULTS

Out of 1,922 patients who were operated on for breast tumor, 521 first met the inclusion and exclusion criteria. 154 out of these 521 patients agreed to take part in the study. After availability of the final results on tumor staging and the therapy plan for conventional treatment, 80 out of the 154 women had to be excluded from the study. From the remaining 74 patients (48%), however, only 29 (39%) would have agreed to take part in a randomized mistletoe study.

CONCLUSIONS

This confirms our suspicion that the difficulties of enrollment and randomization in the case of mistletoe studies exceed those of studies conducted in conventional oncology. The reasons for this dramatic effect and the possibility of alternative study designs are discussed.

摘要

背景

关于槲寄生疗法的前瞻性随机研究反复表明,在合理时间内纳入适当数量的患者存在一个基本问题。大多数研究都必须面对这个问题。然而,最近的经验表明,在槲寄生治疗癌症患者的情况下,这个问题更为突出。

目的

为一项槲寄生研究招募乳腺癌患者并进行随机分组的可能性。

患者

在28个月的时间里,对因疑似癌症入住海德堡大学妇科医院的每一位患者进行了登记。

结果

在1922例接受乳腺肿瘤手术的患者中,521例首次符合纳入和排除标准。这521例患者中有154例同意参加该研究。在获得肿瘤分期的最终结果和传统治疗的治疗方案后,154名女性中有80例不得不被排除在研究之外。然而,在其余74例患者(48%)中,只有29例(39%)愿意参加槲寄生随机研究。

结论

这证实了我们的怀疑,即槲寄生研究在招募患者和随机分组方面的困难超过了传统肿瘤学研究。本文讨论了这种显著影响的原因以及替代研究设计的可能性。

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