Sagar Stephen M
Juravinski Cancer Center, Canada.
J Soc Integr Oncol. 2006 Winter;4(1):27-39.
Integrative oncology is an evolving evidence-based specialty that uses complementary therapies in concert with medical treatment to enhance its efficacy, improve symptom control, alleviate patient distress and reduce suffering. In North America the evolution of research into complementary therapies was delayed by the narrow focus of the Flexner Report. A government-funded research agenda and incorporation of complementary therapies into medical school curricula have been driven by early evidence of efficacy and patient demand. Integrative oncology focuses on the role of natural health products (botanicals, vitamins, and minerals), nutrition, acupuncture, meditation and other mind-body approaches, music therapy, touch therapies, fitness therapies, and more. Some natural health products, such as herbs and their constituent phytochemicals, may be biologic response modifiers that could increase cancer control. Current research stretches from the laboratory to health services. Institutions are exploring the effectiveness gap in their clinical services and are determining efficacy of complementary therapies through randomized controlled trials. Eventually, the goal is to establish practice guidelines through determining relative effectiveness and value through cost-utility studies. The aim of integrative oncology should be one medicine, not alternative; it should be patient-focused; it should be evidence-based; and it should provide the best care for cancer cure, prevention, symptom control, and quality of life.
整合肿瘤学是一门不断发展的循证医学专业，它将补充疗法与医学治疗相结合，以提高疗效、改善症状控制、减轻患者痛苦并减少折磨。在北美，由于弗莱克斯纳报告的狭隘关注点，补充疗法的研究进展受到了延迟。早期的疗效证据和患者需求推动了政府资助的研究议程，并促使补充疗法纳入医学院课程。整合肿瘤学关注天然健康产品（植物药、维生素和矿物质）、营养、针灸、冥想及其他身心疗法、音乐疗法、触摸疗法、健身疗法等的作用。一些天然健康产品，如草药及其所含的植物化学物质，可能是生物反应调节剂，可增强癌症控制效果。当前的研究范围从实验室延伸至医疗服务领域。各机构正在探索其临床服务中的有效性差距，并通过随机对照试验确定补充疗法的疗效。最终目标是通过成本效用研究确定相对有效性和价值，从而制定实践指南。整合肿瘤学的目标应该是采用一种医学方法，而非替代疗法；应以患者为中心；应以证据为基础；并且应为癌症的治愈、预防、症状控制和生活质量提供最佳护理。
