Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel; Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
J Pain Symptom Manage. 2013 Dec;46(6):887-96. doi: 10.1016/j.jpainsymman.2013.02.010. Epub 2013 May 23.
Many cancer patients are using non-herbal nutritional supplements (NHNS), often without informing their oncologists.
To review the literature and summarize the beneficial effects and safety of NHNS in the prevention and reduction of treatment-related symptoms.
Databases were searched for randomized, controlled clinical trials (Jadad score ≥ 2) using AltHealthWatch, Cochrane Database of Systematic Reviews, Embase, MEDLINE, Memorial Sloan-Kettering Integrative Medicine Service Database, Natural Standard Database, and PubMed. The key words searched were the following: alternative and/or complementary medicine, nutritional and/or dietary supplements, quality of life, symptoms and/or side effects, specific toxicities (e.g., neuropathy, mucositis), and specific supplements (e.g., vitamin E, glutamine, etc.).
A number of NHNS products were found to be effective. The incidence and severity of peripheral sensory neuropathy associated with taxane-agents such as paclitaxel can be reduced with vitamin E, glutamine, and acetyl-L-carnitine. Vitamin E and glutamine also have been shown to reduce oral mucositis resulting from radiation and chemotherapy, and glutamine and probiotics can reduce chemotherapy-induced diarrhea.
There is a need to develop an open and nonjudgmental dialogue between oncologists and cancer patients, addressing the needs of the patient while dealing with issues related to the efficacy and safety of these products. Referral of patients to an integrative medicine consultant may help achieve these goals, providing both parties with the option of reaching an informed and respectful decision about treatment.
许多癌症患者在使用非草本营养补充剂（NHNS），通常不会告知他们的肿瘤医生。
综述文献，总结 NHNS 在预防和减轻治疗相关症状方面的有益作用和安全性。
使用 AltHealthWatch、Cochrane 系统评价数据库、Embase、MEDLINE、纪念斯隆-凯特琳综合医学服务数据库、自然标准数据库和 PubMed 等数据库，检索了使用 AltHealthWatch、Cochrane 系统评价数据库、Embase、MEDLINE、纪念斯隆-凯特琳综合医学服务数据库、自然标准数据库和 PubMed 等数据库进行的随机对照临床试验（Jadad 评分≥2）的文献，并检索了替代和/或补充医学、营养和/或膳食补充剂、生活质量、症状和/或副作用、特定毒性（如神经病变、黏膜炎）和特定补充剂（如维生素 E、谷氨酰胺等）的关键词。
发现一些 NHNS 产品有效。维生素 E、谷氨酰胺和乙酰左旋肉碱可降低紫杉醇等紫杉烷类药物相关的周围感觉神经病变的发生率和严重程度。维生素 E 和谷氨酰胺还可减少放化疗引起的口腔黏膜炎，谷氨酰胺和益生菌可减少化疗引起的腹泻。
需要在肿瘤医生和癌症患者之间建立一种开放和非评判性的对话，在满足患者需求的同时，处理这些产品的疗效和安全性相关问题。将患者转介给综合医学顾问可能有助于实现这些目标，为双方提供一个关于治疗的知情和尊重的决策选择。
