Division of Mental Health, St. George's, University of London, London, United Kingdom.
J Pain Symptom Manage. 2011 Apr;41(4):761-7. doi: 10.1016/j.jpainsymman.2010.06.020. Epub 2011 Jan 20.
Cancer-related fatigue (CRF) is a common and distressing symptom affecting patients with cancer. There is an increasing number of drug trials examining potential treatments for CRF. Methylphenidate represents one of the most researched drugs in this area, and an up-to-date assessment of the evidence for its use is needed.
To assess and summarize the increasing evidence for the use of psychostimulants, particularly methylphenidate, in the treatment of CRF.
A systematic review of electronic databases was conducted from inception to the start of October 2009, together with cross-referencing of cited abstracts and hand searching of relevant cancer journals.
A meta-analysis was conducted on five psychostimulant trials (n=426 participants). The overall standardized mean difference was -0.28 (95% confidence interval [CI] -0.48, -0.09; P=0.005), although several trials failed to find any benefit over placebo. There were no differences in the frequency of adverse events between methylphenidate and placebo: combined odds ratio 1.24 (95% CI 0.42, 3.62).
There is preliminary evidence for the use of psychostimulants to treat CRF. The absolute numbers still remain small, and further confirmation is needed before firm recommendations on their usage and safety can be made in the treatment of CRF.
癌症相关性乏力（CRF）是一种常见且令人痛苦的症状，影响着癌症患者。目前有越来越多的药物试验正在研究潜在的 CRF 治疗方法。哌醋甲酯是该领域研究最多的药物之一，因此需要对其使用证据进行最新评估。
评估并总结在治疗 CRF 中使用精神兴奋剂，特别是哌醋甲酯的不断增加的证据。
从研究开始到 2009 年 10 月初，对电子数据库进行了系统的检索，并对引用摘要进行了交叉参考，以及对相关癌症期刊进行了手工检索。
对 5 项精神兴奋剂试验（n=426 名参与者）进行了荟萃分析。总体标准化均数差为-0.28（95%置信区间[-0.48，-0.09]；P=0.005），尽管有几个试验未能发现哌醋甲酯与安慰剂相比有任何益处。哌醋甲酯与安慰剂之间不良反应的发生频率无差异：合并比值比 1.24（95%置信区间 0.42，3.62）。
有初步证据表明使用精神兴奋剂来治疗 CRF。绝对数字仍然较小，在对其在 CRF 治疗中的使用和安全性做出确切建议之前，还需要进一步的确认。
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