Mertens Ann C, Sencer Susan, Myers Cynthia D, Recklitis Christopher, Kadan-Lottick Nina, Whitton John, Marina Neyssa, Robison Leslie L, Zeltzer Lonnie
University of Minnesota, Minneapolis, Minnesota, USA.
Pediatr Blood Cancer. 2008 Jan;50(1):90-7. doi: 10.1002/pbc.21177.
Little information is available on the use of complementary and alternative medicine (CAM) in long-term survivors of childhood and adolescent cancer.
The Childhood Cancer Survivor Study (CCSS) is a resource evaluating the long-term effects of cancer and associated therapies in 5-year survivors of childhood and adolescent cancer diagnosed between 1970 and 1986 before the age of 21 years. A survey of CAM use during the previous year was distributed in 2000-2001 and completed by 9,984 survivors and 2,474 sibling controls.
CAM use reporting was similar in cases (39.4%) and siblings (41.1%). Compared to female siblings, female survivors were more likely to use biofeedback (odds ratio (OR) = 3.3; 95% CI = 1.0-10.8) and hypnosis/guided imagery (OR = 3.2; 95% CI = 1.6-6.8); male survivors were more likely than male siblings to use herbal remedies (OR = 1.3; 95% CI = 1.1-1.6). Factors associated with CAM use in survivors included elevated scores on the brief symptom inventory (BSI)-18 (OR = 1.6; 95% CI = 1.3-1.9), prolonged pain (OR = 1.5; 95% CI = 1.3-1.7), and having seen a physician in the past 2 years (OR = 1.6; 95% CI = 1.4-1.8). Survivors reporting low alcohol intake and excellent or good general health reported lower levels of CAM use (OR = 0.7; 95% CI = 0.7-0.8 and OR = 0.8; 95% CI = 0.7-0.9, respectively).
Survivors have a similar reported use of CAM compared to a sibling cohort. However, our data suggest that survivors turn to CAM for specific symptoms related to previous diagnosis and treatment. Future research is needed to determine whether CAM use reflects unmet health needs in this population.
关于儿童和青少年癌症长期幸存者使用补充和替代医学(CAM)的信息较少。
儿童癌症幸存者研究(CCSS)是一项资源研究,评估1970年至1986年间21岁之前诊断的儿童和青少年癌症5年幸存者中癌症及相关治疗的长期影响。2000年至2001年进行了一项关于上一年CAM使用情况的调查,9984名幸存者和2474名同胞对照完成了该调查。
病例组(39.4%)和同胞组(41.1%)报告的CAM使用率相似。与女性同胞相比,女性幸存者更有可能使用生物反馈疗法(优势比(OR)=3.3;95%置信区间(CI)=1.0-10.8)和催眠/引导意象疗法(OR=3.2;95%CI=1.6-6.8);男性幸存者比男性同胞更有可能使用草药疗法(OR=1.3;95%CI=1.1-1.6)。幸存者使用CAM的相关因素包括简短症状量表(BSI)-18得分升高(OR=1.6;95%CI=1.3-1.9)、长期疼痛(OR=1.5;95%CI=1.3-1.7)以及在过去2年看过医生(OR=1.6;95%CI=1.4-1.8)。报告酒精摄入量低且总体健康状况良好或优秀的幸存者报告的CAM使用水平较低(OR分别为0.7;95%CI=0.7-0.8和OR=0.8;95%CI=0.7-0.9)。
与同胞队列相比,幸存者报告的CAM使用率相似。然而,我们的数据表明,幸存者因与先前诊断和治疗相关的特定症状而求助于CAM。需要未来的研究来确定CAM的使用是否反映了该人群未满足的健康需求。