Kings College London, London, UK.
Integr Cancer Ther. 2013 Jul;12(4):276-90. doi: 10.1177/1534735413485816. Epub 2013 Apr 30.
Fatigue, experienced by patients during and following cancer treatment, is a significant clinical problem. It is a prevalent and distressing symptom yet pharmacological interventions are used little and confer limited benefit for patients. However, many cancer patients use some form of complementary and alternative medicine (CAM), and some evidence suggests it may relieve fatigue. A systematic review was conducted to appraise the effectiveness of CAM interventions in ameliorating cancer-related fatigue. Systematic searches of biomedical, nursing, and specialist CAM databases were conducted, including Medline, Embase, and AMED. Included papers described interventions classified as CAM by the National Centre of Complementary and Alternative Medicine and evaluated through randomized controlled trial (RCT) or quasi-experimental design. Twenty studies were eligible for the review, of which 15 were RCTs. Forms of CAM interventions examined included acupuncture, massage, yoga, and relaxation training. The review identified some limited evidence suggesting hypnosis and ginseng may prevent rises in cancer-related fatigue in people undergoing treatment for cancer and acupuncture and that biofield healing may reduce cancer-related fatigue following cancer treatments. Evidence to date suggests that multivitamins are ineffective at reducing cancer-related fatigue. However, trials incorporated within the review varied greatly in quality; most were methodologically weak and at high risk of bias. Consequently, there is currently insufficient evidence to conclude with certainty the effectiveness or otherwise of CAM in reducing cancer-related fatigue. The design and methods employed in future trials of CAM should be more rigorous; increasing the strength of evidence should be a priority.
疲劳是癌症患者在治疗期间和治疗后经历的一个严重的临床问题。它是一种普遍存在且令人痛苦的症状，但药物干预的应用很少，并且对患者的益处有限。然而，许多癌症患者使用某种形式的补充和替代医学（CAM），并且有一些证据表明它可能缓解疲劳。进行了一项系统评价，以评估 CAM 干预措施缓解癌症相关疲劳的有效性。系统地搜索了生物医学、护理和专业 CAM 数据库，包括 Medline、Embase 和 AMED。纳入的论文描述了被国家补充和替代医学中心（National Centre of Complementary and Alternative Medicine）归类为 CAM 的干预措施，并通过随机对照试验（RCT）或准实验设计进行了评估。有 20 项研究符合审查条件，其中 15 项为 RCT。所检查的 CAM 干预形式包括针灸、按摩、瑜伽和放松训练。该综述发现了一些有限的证据表明，催眠和人参可能预防接受癌症治疗的人癌症相关疲劳的增加，以及生物场治疗可能减少癌症治疗后的癌症相关疲劳。迄今为止的证据表明，多种维生素在减轻癌症相关疲劳方面无效。然而，综述中纳入的试验在质量上差异很大；大多数在方法上都很薄弱，存在很高的偏倚风险。因此，目前尚无确凿证据可以确定 CAM 在减轻癌症相关疲劳方面的有效性或无效性。CAM 未来试验采用的设计和方法应更加严格；增加证据的强度应是当务之急。
