Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul.
Research Institute and Hospital, National Cancer Center, Goyang.
Ann Oncol. 2013 Feb;24(2):489-494. doi: 10.1093/annonc/mds469. Epub 2012 Oct 30.
We evaluated whether complementary and alternative medicine (CAM) use influenced outcomes [survival and health-related quality of life (HRQOL)] of cancer patients whose condition had just been judged terminal.
From July 2005 to October 2006, we conducted a prospective cohort study of 481 terminally ill cancer patients at 11 university hospitals and the National Cancer Center in Korea. We assessed how the use of CAM affected HRQOL and survival.
In a follow-up of 481 patients and 163.8 person-years, we identified 466 deceased cases. On multivariate analyses, CAM users did not have better survival compared with nonusers [adjusted hazard ratio (aHR), 0.91; 95% confidence interval (CI) 0.74-1.10]. Among mind-body interventions, prayer showed significantly worse survival (aHR, 1.56; 95% CI, 1.00-2.43). Clinically, CAM users reported significantly worse cognitive functioning (-11.6 versus -1.3; P < 0.05) and fatigue (9.9 versus -1.0; P < 0.05) than nonusers. Compared with nonusers in subgroup analysis, users of alternative medical treatments, prayer, vitamin supplements, mushrooms, or rice and cereal reported clinically significant worse changes in some HRQOL subscales.
While CAM did not provide any definite survival benefit, CAM users reported clinically significant worse HRQOLs.
我们评估了补充和替代医学（CAM）的使用是否会影响那些病情刚刚被判定为晚期的癌症患者的结局[生存率和健康相关生活质量（HRQOL）]。
2005 年 7 月至 2006 年 10 月，我们对韩国 11 所大学医院和国家癌症中心的 481 名晚期癌症患者进行了前瞻性队列研究。我们评估了 CAM 的使用如何影响 HRQOL 和生存率。
在对 481 名患者和 163.8 人年的随访中，我们发现了 466 例死亡病例。在多变量分析中，CAM 使用者的生存率不比非使用者好[调整后的危险比（aHR），0.91；95%置信区间（CI）0.74-1.10]。在身心干预中，祈祷显示出明显更差的生存率（aHR，1.56；95%CI，1.00-2.43）。在临床上，CAM 使用者报告的认知功能（-11.6 与-1.3；P<0.05）和疲劳（9.9 与-1.0；P<0.05）明显比非使用者差。在亚组分析中，与非使用者相比，替代医学治疗、祈祷、维生素补充剂、蘑菇、大米和谷物的使用者报告了一些 HRQOL 子量表的临床显著更差的变化。
虽然 CAM 没有提供任何明确的生存获益，但 CAM 使用者报告了临床显著更差的 HRQOL。
