Cassileth B R, Lusk E J, Guerry D, Blake A D, Walsh W P, Kascius L, Schultz D J
Psychosocial Research Programs, University of Pennsylvania, Philadelphia.
N Engl J Med. 1991 Apr 25;324(17):1180-5. doi: 10.1056/NEJM199104253241706.
Cancer treatments without proved efficacy have achieved new levels of popularity, particularly among well-educated patients. The value of these therapies is vigorously debated.
We compared the length of survival and quality of life in patients who received treatment at a prominent unorthodox cancer clinic in addition to conventional treatment and in matched control patients from an academic cancer center who received only conventional treatment. All the patients had documented extensive malignant disease associated with a predicted median survival time of less than one year. The study sample consisted of 78 pairs of patients matched according to sex, race, age, diagnosis, and time from the diagnosis of metastatic or recurrent disease, who were enrolled over a period of 3 1/2 years. Periodic follow-up (approximately every two months) continued until death.
There was no difference between the two patient groups in length of survival. Median survival for both groups was 15 months (P = 0.22; relative risk, 1.23; 95 percent confidence interval, 0.88 to 1.72). Quality-of-life scores were consistently better among conventionally treated patients from enrollment on.
For this sample of patients with extensive disease and for this particular unorthodox treatment regimen, conventional and unorthodox treatments produced similar results.
未经证实疗效的癌症治疗方法越来越受欢迎，尤其是在受过良好教育的患者中。这些疗法的价值存在激烈争论。
我们比较了在一家著名的非正统癌症诊所接受常规治疗之外还接受其他治疗的患者与来自学术癌症中心仅接受常规治疗的匹配对照患者的生存时长和生活质量。所有患者均有记录显示患有广泛的恶性疾病，预计中位生存时间不到一年。研究样本包括78对患者，根据性别、种族、年龄、诊断以及从转移性或复发性疾病诊断开始计算的时间进行匹配，这些患者在3年半的时间里入组。定期随访（大约每两个月一次）持续到患者死亡。
两组患者的生存时长没有差异。两组的中位生存时间均为15个月（P = 0.22；相对风险，1.23；95%置信区间，0.88至1.72）。从入组开始，接受常规治疗的患者的生活质量评分一直更好。
对于这个患有广泛疾病的患者样本以及这种特定的非正统治疗方案，常规治疗和非正统治疗产生了相似的结果。
