医学大麻对癌症症状缓解效果的感知存在性别差异：魁北克大麻登记处的研究结果。
Sex differences exist in the perceived relief of cancer symptoms with medical cannabis: results from the Quebec Cannabis Registry.
机构信息
McGill Nutrition and Performance Laboratory, 5252 de Maisonneuve Blvd West, Suite 105-B, Montreal, QC, H4A 3S5, Canada.
Supportive and Palliative Care Division, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, QC, H4A 3J1, Canada.
出版信息
Support Care Cancer. 2022 Oct;30(10):7863-7871. doi: 10.1007/s00520-022-07193-1. Epub 2022 Jun 20.
PURPOSE
This study explored whether symptom relief differs by sex in patients with cancer receiving medical cannabis (MC) therapy.
METHODS
This is an analysis of data collected from patients with cancer enrolled in the Quebec Cannabis Registry. MC was initiated for the therapeutic management of cancer symptoms. Patients completed the revised Edmonton Symptom Assessment System (ESAS-r) questionnaire at baseline and 3-month follow-up. We examined the interaction between sex and time on each ESAS-r symptom and the interaction between time and tetrahydrocannabinol:cannabidiol (THC:CBD) ratios for each sex on total symptom burden.
RESULTS
The analysis included 358 patients (M: 171). There were no sex differences in baseline ESAS-r scores. Three months of MC therapy led to significant improvements in pain (M: - 1.4 ± 0.3, p < 0.001; F: - 1.1 ± 0.3, p < 0.01), tiredness (M: - 1.7 ± 0.4, p < 0.001; F: - 1.2 ± 0.4, p < 0.05), anxiety (M: - 1.1 ± 0.4, p < 0.05; F: - 1.2 ± 0.4, p < 0.001), and well-being (M: - 1.2 ± 0.4, p < 0.05; F: - 1.4 ± 0.4, p < 0.01) in both sexes. Only F perceived improved drowsiness (- 1.1 ± 0.4, p < 0.05), nausea (- 0.9 ± 0.3, p < 0.05), lack of appetite (- 1.7 ± 0.4, p < 0.001), and shortness of breath (- 0.9 ± 0.3, p < 0.05). From baseline to 3-month follow-up, THC-dominant MC significantly reduced pain (- 1.52 ± 0.52, p < 0.05) in M, whereas in F it diminished nausea (- 2.52 ± 0.70, p < 0.01) and improved well-being (- 2.41 ± 0.79, p < 0.05). THC:CBD-balanced products significantly reduced pain (- 1.48 ± 0.49, p < 0.05), tiredness (- 1.82 ± 0.62, p < 0.05), anxiety (- 1.83 ± 0.54, p < 0.05), and improved well-being (- 2.01 ± 0.56, p < 0.01) in M. CBD-dominant products did not offer significant symptom relief in either sex.
CONCLUSION
The perceived relief of cancer symptoms from MC differs between sexes. More randomized controlled trials are needed to confirm our findings.
目的
本研究旨在探讨在接受医用大麻（MC）治疗的癌症患者中，性别是否会影响症状缓解。
方法
这是对参加魁北克大麻登记处的癌症患者数据进行的分析。MC 是为了治疗癌症症状而开始使用的。患者在基线和 3 个月随访时完成了修订后的埃德蒙顿症状评估系统（ESAS-r）问卷。我们检查了性别和时间对每个 ESAS-r 症状的相互作用，以及每个性别的四氢大麻酚：大麻二酚（THC：CBD）比值与总症状负担之间的相互作用。
结果
分析包括 358 名患者（男性 171 名）。基线 ESAS-r 评分在性别之间没有差异。3 个月的 MC 治疗导致疼痛（男性：-1.4±0.3，p<0.001；女性：-1.1±0.3，p<0.01）、疲倦（男性：-1.7±0.4，p<0.001；女性：-1.2±0.4，p<0.05）、焦虑（男性：-1.1±0.4，p<0.05；女性：-1.2±0.4，p<0.001）和幸福感（男性：-1.2±0.4，p<0.05；女性：-1.4±0.4，p<0.01）均显著改善。只有女性的嗜睡（-1.1±0.4，p<0.05）、恶心（-0.9±0.3，p<0.05）、食欲减退（-1.7±0.4，p<0.001）和呼吸急促（-0.9±0.3，p<0.05）得到改善。从基线到 3 个月随访，THC 优势型 MC 显著减轻了男性的疼痛（-1.52±0.52，p<0.05），而在女性中，它减轻了恶心（-2.52±0.70，p<0.01）和改善了幸福感（-2.41±0.79，p<0.05）。THC：CBD 平衡型产品显著减轻了男性的疼痛（-1.48±0.49，p<0.05）、疲倦（-1.82±0.62，p<0.05）、焦虑（-1.83±0.54，p<0.05）和幸福感（-2.01±0.56，p<0.01）。CBD 优势型产品在两性中均未提供显著的症状缓解。
结论
从 MC 中获得的癌症症状缓解在性别之间存在差异。需要更多的随机对照试验来证实我们的发现。
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