Department of Investigational Cancer Therapeutics (Phase 1 Program), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Cancer. 2011 Nov 15;117(22):5142-50. doi: 10.1002/cncr.26164. Epub 2011 Apr 28.
A key end point of early cancer clinical trials is the assessment of toxicities and their possible association with new experimental drugs. Therefore, the concurrent use of complementary and alternative medicine (CAM) in patients with advanced malignancies seen in a dedicated phase 1 clinic was evaluated.
An investigator-designed survey was anonymously completed by patients seen in the phase 1 clinic. Pharmacologic CAM included any oral, topical, or intravenous agent, including vitamins, dietary supplements, and herbal products. Nonpharmacologic CAM included prayer, meditation, hypnosis, massage, and acupuncture.
Of the 404 patients approached about completing the CAM survey, 394 (98%) agreed to respond, and 309 (78%) surveys were returned. Of those 309 patients, 162 (52%) used 1 or more CAM. Of the 162 CAM users, 77% utilized pharmacologic CAM, 71% used nonpharmacologic CAM, and 48% used both modalities. The most frequent CAM used were vitamins (70%), prayer (57%), and herbal products (26%). CAM utilization was not significantly associated with race, age, level of education, employment, or income level but was used more by women than men (P < .01). There was no statistically significant association between the use of CAM and quality of life as perceived by patients. Of the CAM users, 43% of patients had been using CAM for >5 years. Only 5% reported having side effects from using CAM, whereas 23% did not fully disclose their CAM use to their physicians.
CAM usage is common in patients with advanced malignancies seen in a phase 1 clinic.
早期癌症临床试验的一个关键终点是评估毒性及其与新的实验性药物的可能关联。因此,评估了在专门的 1 期临床诊所中看到的晚期恶性肿瘤患者同时使用补充和替代医学(CAM)的情况。
研究者设计的调查匿名由 1 期临床诊所的患者完成。药理 CAM 包括任何口服、局部或静脉制剂,包括维生素、膳食补充剂和草药产品。非药理 CAM 包括祈祷、冥想、催眠、按摩和针灸。
在被邀请完成 CAM 调查的 404 名患者中,有 394 名(98%)同意回答,有 309 名(78%)调查回复。在这 309 名患者中,有 162 名(52%)使用了 1 种或多种 CAM。在 162 名 CAM 用户中,有 77%使用了药理 CAM,71%使用了非药理 CAM,48%同时使用了这两种方法。最常使用的 CAM 是维生素(70%)、祈祷(57%)和草药产品(26%)。CAM 的使用与种族、年龄、教育程度、就业和收入水平没有显著关联,但女性比男性更常使用(P<.01)。CAM 的使用与患者感知的生活质量之间没有统计学上的显著关联。在 CAM 用户中,有 43%的患者使用 CAM 超过 5 年。只有 5%的患者报告因使用 CAM 而出现副作用,而 23%的患者没有向医生充分披露他们的 CAM 使用情况。
在 1 期临床诊所中看到的晚期恶性肿瘤患者中,CAM 的使用很常见。