Cassileth Barrie R, Deng Gary E, Gomez Jorge E, Johnstone Peter A S, Kumar Nagi, Vickers Andrew J
Laurance S. Rockefeller Chair in Integrative Medicine, Chief, Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, 1429 First Ave at Seventy-Fourth St, New York, NY 10021, USA.
Chest. 2007 Sep;132(3 Suppl):340S-354S. doi: 10.1378/chest.07-1389.
This chapter aims to differentiate between "alternative" therapies, often promoted falsely as viable options to mainstream lung cancer treatment, and complementary therapies, adjunctive, effective techniques that treat symptoms associated with cancer and its mainstream treatment, and to describe the evidence base for use of complementary therapies.
A multidisciplinary panel of experts in oncology and integrative medicine evaluated the evidence for complementary (not alternative) therapies in the care of patients with lung cancer. Because few complementary modalities are geared to patients with only a single cancer diagnosis, symptom-control research conducted with other groups of patients with cancer was also included. Data on complementary therapies such as acupuncture, massage therapy, mind-body therapies, herbs and other botanicals, and exercise were evaluated. Recommendations were based on the strength of evidence and the risk-to-benefit ratio.
Patients with lung and other poor-outlook cancers are particularly vulnerable to heavily promoted claims for unproved or disproved "alternatives." Inquiring about patients' use of these therapies should be routine because these practices may be harmful and can delay or impair treatment. Mind-body modalities and massage therapy can reduce anxiety, mood disturbance, and chronic pain. Acupuncture assists the control of pain and other side effects and helps reduce levels of pain medication required. Trials of acupuncture for chemotherapy-induced neuropathy and postthoracotomy pain show promising results. Herbal products and other dietary supplements should be evaluated for side effects and potential interactions with chemotherapy and other medications.
Complementary therapies have an increasingly important role in the control of symptoms associated with cancer and cancer treatment.
本章旨在区分常常被虚假宣传为肺癌主流治疗可行选择的“替代”疗法，以及辅助治疗癌症及其主流治疗相关症状的补充疗法，并描述补充疗法的证据基础。
一个由肿瘤学和综合医学专家组成的多学科小组评估了补充（而非替代）疗法在肺癌患者护理中的证据。由于很少有补充疗法专门针对仅患有单一癌症诊断的患者，因此也纳入了对其他癌症患者群体进行的症状控制研究。对针灸、按摩疗法、身心疗法、草药及其他植物药、运动等补充疗法的数据进行了评估。建议基于证据强度和风险效益比。
肺癌及其他预后不良癌症患者特别容易受到对未经证实或已被证伪的“替代疗法”大力宣传的影响。询问患者对这些疗法的使用情况应成为常规操作，因为这些做法可能有害，会延误或损害治疗。身心疗法和按摩疗法可减轻焦虑、情绪障碍和慢性疼痛。针灸有助于控制疼痛和其他副作用，并有助于减少所需的止痛药用量。针对化疗引起的神经病变和开胸术后疼痛的针灸试验显示出有前景的结果。应评估草药产品和其他膳食补充剂的副作用以及与化疗和其他药物的潜在相互作用。
补充疗法在控制与癌症及癌症治疗相关的症状方面发挥着越来越重要的作用。
