The Canadian College of Naturopathic Medicine, Toronto, ON, Canada.
Integr Cancer Ther. 2012 Dec;11(4):293-303. doi: 10.1177/1534735411425484. Epub 2011 Oct 21.
Melatonin (MLT) is known to possess potent antioxidant, antiproliferative, immune-modulating, and hormone-modulating properties. Clinical evidence suggests that MLT may have a possible role in the treatment of cancer. The authors systematically reviewed the effects of MLT in conjunction with chemotherapy, radiotherapy, supportive care, and palliative care on 1-year survival, complete response, partial response, stable disease, and chemotherapy-associated toxicities.
The authors searched 7 databases: MEDLINE (1966-February 2010), AMED (1985-February 2010), Alt HealthWatch (1995-February 2010), CINAHL (1982-February 2010), Nursing and Allied Health Collection: Basic (1985-February 2010), the Cochrane Database (2009), and the Chinese database CNKI (1979-February 2010). They included all trials that randomized patients to treatment, including MLT or a similar control group without MLT.
The authors included data from 21 clinical trials, all of which dealt with solid tumors. The pooled relative risk (RR) for 1-year mortality was 0.63 (95% confidence interval [CI] = 0.53-0.74; P < .001). Improved effect was found for complete response, partial response, and stable disease with RRs of 2.33 (95% CI = 1.29-4.20), 1.90 (1.43-2.51), and 1.51 (1.08-2.12), respectively. In trials combining MLT with chemotherapy, adjuvant MLT decreased 1-year mortality (RR = 0.60; 95% CI = 0.54-0.67) and improved outcomes of complete response, partial response, and stable disease; pooled RRs were 2.53 (1.36-4.71), 1.70 (1.37-2.12), and 1.15 (1.00-1.33), respectively. In these studies, MLT also significantly reduced asthenia, leucopenia, nausea and vomiting, hypotension, and thrombocytopenia.
MLT may benefit cancer patients who are also receiving chemotherapy, radiotherapy, supportive therapy, or palliative therapy by improving survival and ameliorating the side effects of chemotherapy.
褪黑素（MLT）具有强大的抗氧化、抗增殖、免疫调节和激素调节特性。临床证据表明，褪黑素可能在癌症治疗中具有一定的作用。作者系统地综述了 MLT 与化疗、放疗、支持治疗和姑息治疗联合应用对 1 年生存率、完全缓解、部分缓解、疾病稳定和化疗相关毒性的影响。
作者检索了 7 个数据库：MEDLINE（1966 年-2010 年 2 月）、AMED（1985 年-2010 年 2 月）、Alt HealthWatch（1995 年-2010 年 2 月）、CINAHL（1982 年-2010 年 2 月）、Nursing and Allied Health Collection：Basic（1985 年-2010 年 2 月）、Cochrane 数据库（2009 年）和中国数据库 CNKI（1979 年-2010 年 2 月）。他们纳入了所有将患者随机分配到治疗组（包括 MLT 或无 MLT 的相似对照组）的试验。
作者纳入了 21 项临床试验的数据，均涉及实体瘤。1 年死亡率的合并相对风险（RR）为 0.63（95%置信区间[CI]：0.53-0.74；P<0.001）。完全缓解、部分缓解和疾病稳定的效果更好，RR 分别为 2.33（95% CI：1.29-4.20）、1.90（1.43-2.51）和 1.51（1.08-2.12）。在将 MLT 与化疗联合的试验中，辅助 MLT 降低了 1 年死亡率（RR=0.60；95%CI：0.54-0.67），并改善了完全缓解、部分缓解和疾病稳定的结果；合并 RR 分别为 2.53（1.36-4.71）、1.70（1.37-2.12）和 1.15（1.00-1.33）。在这些研究中，MLT 还显著减少了乏力、白细胞减少、恶心和呕吐、低血压和血小板减少。
MLT 可能通过改善生存和减轻化疗的副作用，使同时接受化疗、放疗、支持治疗或姑息治疗的癌症患者受益。
