Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT; Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, CT.
J Natl Cancer Inst. 2018 Jan 1;110(1). doi: 10.1093/jnci/djx145.
There is limited available information on patterns of utilization and efficacy of alternative medicine (AM) for patients with cancer. We identified 281 patients with nonmetastatic breast, prostate, lung, or colorectal cancer who chose AM, administered as sole anticancer treatment among patients who did not receive conventional cancer treatment (CCT), defined as chemotherapy, radiotherapy, surgery, and/or hormone therapy. Independent covariates on multivariable logistic regression associated with increased likelihood of AM use included breast or lung cancer, higher socioeconomic status, Intermountain West or Pacific location, stage II or III disease, and low comorbidity score. Following 2:1 matching (CCT = 560 patients and AM = 280 patients) on Cox proportional hazards regression, AM use was independently associated with greater risk of death compared with CCT overall (hazard ratio [HR] = 2.50, 95% confidence interval [CI] = 1.88 to 3.27) and in subgroups with breast (HR = 5.68, 95% CI = 3.22 to 10.04), lung (HR = 2.17, 95% CI = 1.42 to 3.32), and colorectal cancer (HR = 4.57, 95% CI = 1.66 to 12.61). Although rare, AM utilization for curable cancer without any CCT is associated with greater risk of death.
关于癌症患者使用替代医学(AM)的模式和疗效,目前信息有限。我们确定了 281 名患有非转移性乳腺癌、前列腺癌、肺癌或结直肠癌的患者,他们选择了 AM,作为未接受常规癌症治疗(CCT)的患者的单一抗癌治疗,CCT 定义为化疗、放疗、手术和/或激素治疗。多变量逻辑回归分析的独立协变量与 AM 使用可能性增加相关,包括乳腺癌或肺癌、较高的社会经济地位、落基山脉以西或太平洋地区、II 期或 III 期疾病以及较低的合并症评分。在 Cox 比例风险回归中进行 2:1 匹配(CCT = 560 名患者,AM = 280 名患者)后,与 CCT 相比,AM 的使用与总体死亡风险增加独立相关(风险比 [HR] = 2.50,95%置信区间 [CI] = 1.88 至 3.27),并且在乳腺癌(HR = 5.68,95% CI = 3.22 至 10.04)、肺癌(HR = 2.17,95% CI = 1.42 至 3.32)和结直肠癌(HR = 4.57,95% CI = 1.66 至 12.61)亚组中也是如此。尽管罕见,但对于没有任何 CCT 的可治愈癌症,使用 AM 与更高的死亡风险相关。