De Feo Giulia, Case Amy A, Crawford Gregory B, Hui David, To Josephine, Sbrana Andrea, Alderman Bryony, Mukhopadhyay Sandip, Bouleuc Carole, Amano Koji, Tanco Kimberson, Garsed Jessica, Davis Mellar
Department of Medical Oncology and Haematology, Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale Tumori Di Milano, Milan, Italy.
Division of Geriatrics and Palliative Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Support Care Cancer. 2023 Feb 21;31(3):176. doi: 10.1007/s00520-023-07628-3.
During the treatment of cancer, 18% of patients use cannabis for symptom management. Anxiety, depression, and sleep disturbances are common symptoms in cancer. A systematic review of the evidence for cannabis use for psychological symptoms in cancer patients was undertaken to develop a guideline.
A literature search of randomized trials and systematic reviews was undertaken up to November 12, 2021. Studies were independently assessed for evidence by two authors and then evaluated by all authors for approval. The literature search involved MEDLINE, CCTR, EMBASE, and PsychINFO databases. Inclusion criteria included randomized control trials and systematic reviews on cannabis versus placebo or active comparator in patients with cancer and psychological symptom management (anxiety, depression, and insomnia).
The search yielded 829 articles; 145 from Medline, 419 from Embase, 62 from PsychINFO, and 203 from CCTR. Two systematic reviews and 15 randomized trials (4 on sleep, 5 on mood, 6 on both) met eligibility criteria. However, no studies specifically assessed the efficacy of cannabis on psychological symptoms as primary outcomes in cancer patients. The studies varied widely in terms of interventions, control, duration, and outcome measures. Six of 15 RCTs suggested benefits (five for sleep, one for mood).
There is no high-quality evidence to recommend the use of cannabis as an intervention for psychological symptoms in patients with cancer until more high-quality research demonstrates benefit.
在癌症治疗期间，18%的患者使用大麻来管理症状。焦虑、抑郁和睡眠障碍是癌症患者常见的症状。为制定一项指南，对癌症患者使用大麻治疗心理症状的证据进行了系统评价。
截至2021年11月12日，对随机试验和系统评价进行了文献检索。由两位作者独立评估研究证据，然后由所有作者进行评估以获得批准。文献检索涉及MEDLINE、CCTR、EMBASE和PsychINFO数据库。纳入标准包括关于大麻与安慰剂或活性对照物在癌症患者心理症状管理（焦虑、抑郁和失眠）方面的随机对照试验和系统评价。
检索共得到829篇文章；其中145篇来自Medline，419篇来自Embase，62篇来自PsychINFO，203篇来自CCTR。两项系统评价和15项随机试验（4项关于睡眠，5项关于情绪，6项两者都涉及）符合纳入标准。然而，没有研究专门评估大麻对癌症患者心理症状作为主要结局的疗效。这些研究在干预措施、对照、持续时间和结局测量方面差异很大。15项随机对照试验中有6项显示出益处（5项关于睡眠，I项关于情绪）。
在更多高质量研究证明有益之前，没有高质量证据推荐将大麻作为癌症患者心理症状的干预措施。
