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全球传统医学和补充医学在儿童癌症中的应用:一项系统评价。

Global Use of Traditional and Complementary Medicine in Childhood Cancer: A Systematic Review.

作者信息

Diorio Caroline, Lam Catherine G, Ladas Elena J, Njuguna Festus, Afungchwi Glenn M, Taromina Katherine, Marjerrison Stacey

机构信息

Caroline Diorio and Stacey Marjerrison, McMaster Children's Hospital, Hamilton, Ontario, Canada; Catherine G. Lam, St. Jude Children's Research Hospital, Memphis, TN; Elena J. Ladas and Katherine Taromina, Columbia University Medical Center, New York City, NY; Festus Njuguna, Moi University, Eldoret, Kenya; and Glenn M. Afungchwi, Banso Baptist Hospital, Kumbo, Cameroon.

出版信息

J Glob Oncol. 2017 Dec;3(6):791-800. doi: 10.1200/JGO.2016.005587. Epub 2016 Nov 9.

Abstract

Purpose Traditional and complementary medicine (T&CM) strategies are commonly used in pediatric oncology. Patterns may vary based on country income. We systematically reviewed published studies describing T&CM use among pediatric oncology patients in low-income countries (LIC/LMIC), middle-income countries (UMIC), and high-income countries (HIC). Objectives included describing estimated prevalence of use, reasons for use, perceived effectiveness, modalities used, rates of disclosure, and reporting of delayed or abandoned treatment. Methods MEDLINE, EMBASE, Global Health, CINAHL, PsycINFO, Allied and Complementary Medicine Database, Cochrane Database of Systematic Reviews, and ProceedingsFirst were searched. Inclusion criteria were primary studies involving children younger than the age of 18 years, undergoing active treatment of cancer, and any T&CM use. Exclusion criteria included no pediatric oncology-specific outcomes and studies involving only children off active treatment. Data were extracted by two reviewers using a systematic data extraction form determined a priori. Results Sixty-five studies published between 1977 and 2015 were included, representing 61 unique data sets and 7,219 children from 34 countries. The prevalence of T&CM use ranged from 6% to 100%. Median rates of use were significantly different in LIC/LMIC (66.7% ± 19%), UMIC (60% ± 26%), and HIC (47.2% ± 20%; P = .02). Rates of disclosure differed significantly by country income, with higher median rates in HIC. Seven studies reported on treatment abandonment or delays. Conclusion The use of T&CM in pediatric oncology is common worldwide, with higher median prevalence of use reported in LIC/LMIC. Further research is warranted to examine the impact on treatment abandonment and delay.

摘要

目的 传统医学与补充医学(T&CM)策略在儿科肿瘤学中普遍使用。其模式可能因国家收入水平而异。我们系统回顾了已发表的研究,这些研究描述了低收入国家(LIC/LMIC)、中等收入国家(UMIC)和高收入国家(HIC)的儿科肿瘤患者使用T&CM的情况。目标包括描述使用的估计患病率、使用原因、感知疗效、使用的方式、披露率以及延迟或放弃治疗的报告情况。方法 检索了MEDLINE、EMBASE、全球健康、CINAHL、PsycINFO、补充与替代医学数据库、Cochrane系统评价数据库和会议论文优先数据库。纳入标准为涉及18岁以下正在接受癌症积极治疗且使用任何T&CM的儿童的原始研究。排除标准包括没有儿科肿瘤学特定结局以及仅涉及停止积极治疗儿童的研究。由两名评审员使用预先确定的系统数据提取表提取数据。结果 纳入了1977年至2015年间发表的65项研究,代表61个独特数据集和来自34个国家的7219名儿童。T&CM的使用率从6%到100%不等。LIC/LMIC(66.7%±19%)、UMIC(60%±26%)和HIC(47.2%±20%;P = 0.02)的中位使用率有显著差异。披露率因国家收入水平而有显著差异,HIC的中位率更高。七项研究报告了治疗放弃或延迟情况。结论 T&CM在全球儿科肿瘤学中的使用很普遍,LIC/LMIC报告的中位使用率更高。有必要进一步研究以检查其对治疗放弃和延迟的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59b0/5735959/4d5d63d4e894/JGO.2016.005587f1.jpg

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