Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Medical Oncology Unit, Department of Internal Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Asian Pac J Cancer Prev. 2021 Dec 1;22(12):3977-3983. doi: 10.31557/APJCP.2021.22.12.3977.
Complementary and Alternative Medicine (CAM) is widely used among cancer patients worldwide. This prospective observational study aimed to show the effect of CAM use on chemotherapy delivery in Thai patients.
During March 2014 to February 2015, the patients with breast, lung or colorectal cancer receiving first cycle chemotherapy at King Chulalongkorn Memorial Hospital were enrolled. The correlation between CAM using and chemotherapy schedule delay and dose reduction, dose intensity, quality of life and adverse event rates were analyzed.
There were 80 (44.20%) patients using CAM among 181 enrolled patients. Seventy six CAM users and 97 non-CAM users receiving 2nd cycle of chemotherapy were included for primary analysis. The chemotherapy schedules were delayed and/or reduced in 40 (52.6%) and 48 (49.5%) in CAM users and non-CAM users, respectively, p =0.681. The mean relative dose intensity (RDI) were 92.4% and 94.1% in CAM and non-CAM users, respectively, p=0.244. However, there were significantly more CAM users receiving chemotherapy less than 90% RDI (34.8% vs 19.8%, p=0.033). As compared to first cycle, at third cycle, the mean QOL score changes were -4.63 (95% CI -2.49-9.27) and -8.02 (-2.36- 9.142) in CAM user and non-CAM user, respectively (p=0.255). There were significantly higher rates of grade 3 or 4 anemia (5.1% vs 0%, p=0.024), and grade 2 malaise (19.0% vs 5.1%, p=0.004) in CAM users.
There were similar overall rates of chemotherapy schedule delay and dose reduction between CAM- and non-CAM users. However, there were less CAM-users achieving 90% chemotherapy RDI.
在世界范围内，癌症患者广泛使用补充和替代医学（CAM）。本前瞻性观察研究旨在展示泰国患者使用 CAM 对化疗实施的影响。
2014 年 3 月至 2015 年 2 月，在朱拉隆功国王纪念医院接受第一周期化疗的乳腺癌、肺癌或结直肠癌患者入组。分析了 CAM 使用与化疗方案延迟和剂量减少、剂量强度、生活质量和不良事件发生率之间的相关性。
在 181 名入组患者中，有 80 名（44.20%）患者使用 CAM。76 名 CAM 使用者和 97 名非 CAM 使用者接受了第二周期化疗，用于主要分析。CAM 使用者和非 CAM 使用者中，化疗方案分别延迟和/或减少 40 例（52.6%）和 48 例（49.5%），p=0.681。CAM 和非 CAM 使用者的平均相对剂量强度（RDI）分别为 92.4%和 94.1%，p=0.244。然而，CAM 使用者中接受低于 90%RDI 的化疗的比例明显更高（34.8%比 19.8%，p=0.033）。与第一周期相比，在第三周期，CAM 使用者和非 CAM 使用者的平均 QOL 评分变化分别为-4.63（95%CI-2.49-9.27）和-8.02（-2.36-9.142）（p=0.255）。CAM 使用者中 3 级或 4 级贫血（5.1%比 0%，p=0.024）和 2 级不适（19.0%比 5.1%，p=0.004）的发生率明显更高。
CAM 使用者和非 CAM 使用者的化疗方案延迟和剂量减少总体发生率相似。然而，CAM 使用者达到 90%化疗 RDI 的比例较低。
