Radiation Oncology Queensland, St. Andrews Cancer Care Center, Toowoomba, Queensland, Australia.
J Altern Complement Med. 2012 Nov;18(11):1014-20. doi: 10.1089/acm.2011.0334. Epub 2012 Aug 20.
Complementary and alternative medicine (CAM) use by patients could interact in unpredictable ways with conventional therapies. This trial was designed to study the prevalence, types, and clinical implications of CAM use in patients with cancer who are receiving radiotherapy.
A validated questionnaire was given to consenting outpatients in this ethics-approved study. Questions specified types of CAM used, clinician knowledge, reason for use, perceived effectiveness, safety, and cost.
Of the 101 assessable questionnaires, 38 patients (38%) of the total patient group used CAM, with vitamins (53%), antioxidants (29%), spiritual/meditation practices (29%), and herbs (18%) being the most commonly used. The intention of CAM use was to improve quality of life in 69% of patients and for either hope of cure or to assist other forms of treatment in 26%. The majority of patients (58%) were using CAM prior to their diagnosis of cancer, with 40% starting at diagnosis or during conventional treatment. Patients spent up to $300/month on CAM use. Patients using CAM were significantly more likely to also receive chemotherapy versus non-CAM users (45% versus 24%, p=0.045). Significantly fewer CAM users expected cure from conventional therapy, compared to non-CAM users (50% versus 75%, p=0.016). More CAM users expected conventional therapy to prolong life (58% versus 32%, p<0.001). Only 40% discussed CAM use with their oncologists.
CAM is commonly used by patients with cancer. CAMs, particularly antioxidants, are being taken which could negate the underlying free-radical tumorcidal effects of radiotherapy. Oncologists need to have greater awareness of this use and of its potential adverse consequences.
患者使用补充和替代医学（CAM）可能会以不可预测的方式与常规疗法相互作用。本试验旨在研究正在接受放疗的癌症患者中 CAM 的使用频率、类型和临床意义。
在这项伦理批准的研究中，向同意的门诊患者发放了经过验证的问卷。问题具体说明了使用的 CAM 类型、临床医生的知识、使用原因、感知效果、安全性和成本。
在 101 份可评估问卷中，共有 38 名（38%）患者使用了 CAM，最常使用的是维生素（53%）、抗氧化剂（29%）、精神/冥想实践（29%）和草药（18%）。69%的患者使用 CAM 的目的是改善生活质量，26%的患者使用 CAM 是为了治愈或辅助其他形式的治疗。大多数患者（58%）在诊断出癌症之前就开始使用 CAM，40%的患者在诊断或接受常规治疗时开始使用。患者每月在 CAM 上的花费高达 300 美元。与非 CAM 用户相比，使用 CAM 的患者更有可能同时接受化疗（45%比 24%，p=0.045）。与非 CAM 用户相比，使用 CAM 的患者明显更少地期望从常规治疗中获得治愈（50%比 75%，p=0.016）。更多的 CAM 用户期望常规治疗能延长生命（58%比 32%，p<0.001）。只有 40%的患者与肿瘤医生讨论了 CAM 的使用情况。
癌症患者普遍使用 CAM。CAM，特别是抗氧化剂，正在被使用，这可能会抵消放疗对自由基的肿瘤杀伤作用。肿瘤医生需要更加了解这种使用情况及其潜在的不良后果。
