South West Sydney Clinical Campuses, School of Medicine & Health, University of New South Wales (UNSW), Sydney, NSW, Australia.
Ingham Institute of Applied Medical Research, Sydney, NSW, Australia.
Palliat Med. 2022 Jun;36(6):912-927. doi: 10.1177/02692163221083437. Epub 2022 Mar 31.
Anorexia (loss of appetite) is a prevalent and distressing symptom in people with cancer, with limited effective interventions. Medicinal cannabis has shown promise in improving appetite-related symptoms in people with cancer.
To assess the efficacy of medicinal cannabis for improving appetite-related symptoms in people with cancer, considering measures and outcomes, interventions and toxicity.
Systematic review with narrative approach to synthesis and meta-analysis.
Databases (MEDLINE, CINAHL, CENTRAL), websites and trials registries were searched from inception to February 2021. Included studies were randomised controlled trials (RCT) in English peer-reviewed journals comparing medicinal cannabis with placebo and/or another intervention. Study quality was assessed using the Cochrane risk of bias tool.
Five studies were included that compared medicinal cannabis interventions (dronabinol, nabilone and cannabis extract) either with placebo ( = 4) or megestrol acetate ( = 1). Measures and trial endpoints varied, but efficacy was demonstrated in one trial only, in which dronabinol significantly improved chemosensory perception and other secondary outcomes (taste of food, premeal appetite, proportion of calories consumed as protein) compared with placebo. Cannabis interventions were generally well tolerated across studies, regardless of the product or dose, although the comprehensive measurement of toxicities was limited.
Evidence from RCTs that medicinal cannabis increases appetite in people with cancer is limited. Measures, outcomes and interventions were variable, and toxicities have not been comprehensively evaluated. Future research should carefully consider biological mechanisms to guide more nuanced selection of endpoints and interventions, including product, dose and administration.
厌食（食欲不振）是癌症患者中常见且令人痛苦的症状，目前有效的干预措施有限。药用大麻已被证明可改善癌症患者的食欲相关症状。
评估药用大麻对改善癌症患者食欲相关症状的疗效，考虑措施和结果、干预措施和毒性。
系统评价，采用叙述性方法进行综合和荟萃分析。
从开始到 2021 年 2 月，在数据库（MEDLINE、CINAHL、CENTRAL）、网站和试验登记处进行了搜索。纳入的研究是在英语同行评审期刊上比较药用大麻与安慰剂和/或其他干预措施的随机对照试验（RCT）。使用 Cochrane 偏倚风险工具评估研究质量。
共纳入 5 项研究，比较了药用大麻干预（大麻二酚、纳布隆和大麻提取物）与安慰剂（ = 4）或甲地孕酮（ = 1）的疗效。测量和试验终点各不相同，但只有一项试验证明了疗效，其中与安慰剂相比，大麻二酚显著改善了化学感觉感知和其他次要结局（食物味道、餐前食欲、摄入的卡路里中蛋白质的比例）。无论产品或剂量如何，大麻干预在研究中通常都具有良好的耐受性，但对毒性的全面评估有限。
RCT 证据表明，药用大麻可增加癌症患者的食欲，但证据有限。措施、结果和干预措施各不相同，毒性尚未得到全面评估。未来的研究应仔细考虑生物学机制，以更细致地选择终点和干预措施，包括产品、剂量和给药方式。
