Kelly Kara M
Division of Pediatric Oncology, Columbia University Medical Center, New York, New York, USA.
Pediatr Blood Cancer. 2008 Feb;50(2 Suppl):490-3; discussion 498. doi: 10.1002/pbc.21402.
Children with cancer frequently use complementary and alternative medicine (CAM), especially in conjunction with conventional therapy. Dietary supplements are a commonly used CAM modality, with the prevalence of supplement use ranging from 35% to 50% of children with cancer in surveys completed in the United States. Less is known about the use of dietary supplements in developing countries. The evidence for some dietary supplements providing some benefit to children with cancer is reviewed. Preliminary studies have shown that antioxidant status may affect chemotherapy tolerance in children with acute lymphoblastic leukemia. Other supplements, including TRAUMEEL S, glutamine, vitamin E, Immunocal, colostrum, and probiotics, may help to reduce gastrointestinal toxicities of chemotherapy and radiation. However, more definitive evidence is needed. Most dietary supplements have not been tested adequately to determine their safety and efficacy, with even less understood about their potential interactions with conventional chemotherapy and radiation. With the greater use of dietary supplements by patients with cancer, increasing scientific attention is being paid to the investigation of these therapies. But research on dietary supplements is complex and usually more difficult than that on conventional medications. Strong research designs are critical in obtaining information that will ultimately influence clinical practice and public awareness.
患癌儿童经常使用补充和替代医学（CAM），尤其是与传统疗法联合使用。膳食补充剂是一种常用的补充和替代医学方式，在美国完成的调查中，患癌儿童使用补充剂的比例在35%至50%之间。在发展中国家，关于膳食补充剂使用情况的了解较少。本文综述了一些膳食补充剂对患癌儿童有益的证据。初步研究表明，抗氧化状态可能会影响急性淋巴细胞白血病患儿对化疗的耐受性。其他补充剂，包括创伤紫、谷氨酰胺、维生素E、免疫球蛋白、初乳和益生菌，可能有助于减轻化疗和放疗的胃肠道毒性。然而，还需要更确凿的证据。大多数膳食补充剂尚未经过充分测试以确定其安全性和有效性，对它们与传统化疗和放疗潜在相互作用的了解更少。随着癌症患者对膳食补充剂的使用增加，这些疗法的研究正受到越来越多的科学关注。但是膳食补充剂的研究很复杂，通常比传统药物的研究更困难。强大的研究设计对于获取最终会影响临床实践和公众认知的信息至关重要。
