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医用大麻对癌症相关疼痛有效:魁北克大麻登记处的结果。

Medical cannabis is effective for cancer-related pain: Quebec Cannabis Registry results.

作者信息

Aprikian Saro, Kasvis Popi, Vigano MariaLuisa, Hachem Yasmina, Canac-Marquis Michelle, Vigano Antonio

机构信息

School of Medicine, Royal College of Surgeons, Dublin, Ireland.

Medical Cannabis Program in Oncology, Cedars Cancer Centre, McGill University Health Centre, Montreal, Quebec, Canada.

出版信息

BMJ Support Palliat Care. 2024 Jan 8;13(e3):e1285-e1291. doi: 10.1136/spcare-2022-004003.

Abstract

OBJECTIVES

To evaluate the safety and effectiveness of medical cannabis (MC) in reducing pain and concurrent medications in patients with cancer.

METHODS

This study analysed data collected from patients with cancer who were part of the Quebec Cannabis Registry. Brief Pain Inventory (BPI), revised Edmonton Symptom Assessment System (ESAS-r) questionnaires, total medication burden (TMB) and morphine equivalent daily dose (MEDD) recorded at 3-month, 6-month, 9-month and 12-month follow-ups were compared with baseline values. Adverse events were also documented at each follow-up visit.

RESULTS

This study included 358 patients with cancer. Thirteen out of 15 adverse events reported in 11 patients were not serious; 2 serious events (pneumonia and cardiovascular event) were considered unlikely related to MC. Statistically significant decreases were observed at 3-month, 6-month and 9-month follow-up for BPI worst pain (5.5±0.7 baseline, 3.6±0.7, 3.6±0.7, 3.6±0.8; p<0.01), average pain (4.1±0.6 baseline, 2.4±0.6, 2.3±0.6, 2.7±0.7; p<0.01), overall pain severity (3.7±0.5 baseline, 2.3±0.6, 2.3±0.6, 2.4±0.6; p<0.01) and pain interference (4.3±0.6 baseline, 2.4±0.6, 2.2±0.6, 2.4±0.7, p<0.01). ESAS-r pain scores decreased significantly at 3-month, 6-month and 9-month follow-up (3.7±0.6 baseline, 2.5±0.6, 2.2±0.6, 2.0±0.7, p<0.01). THC:CBD balanced strains were associated with better pain relief as compared with THC-dominant and CBD-dominant strains. Decreases in TMB were observed at all follow-ups. Decreases in MEDD were observed at the first three follow-ups.

CONCLUSIONS

Real-world data from this large, prospective, multicentre registry indicate that MC is a safe and effective complementary treatment for pain relief in patients with cancer. Our findings should be confirmed through randomised placebo-controlled trials.

摘要

目的

评估医用大麻(MC)在减轻癌症患者疼痛及减少同时使用药物方面的安全性和有效性。

方法

本研究分析了从魁北克大麻登记处的癌症患者收集的数据。将在3个月、6个月、9个月和12个月随访时记录的简明疼痛量表(BPI)、修订的埃德蒙顿症状评估系统(ESAS-r)问卷、总药物负担(TMB)和吗啡当量日剂量(MEDD)与基线值进行比较。每次随访时也记录不良事件。

结果

本研究纳入了358例癌症患者。11例患者报告的15起不良事件中有13起不严重;2起严重事件(肺炎和心血管事件)被认为不太可能与MC有关。在3个月、6个月和9个月随访时,BPI最严重疼痛(基线值5.5±0.7,3.6±0.7,3.6±0.7,3.6±0.8;p<0.01)、平均疼痛(基线值4.1±0.6,2.4±0.6,2.3±0.6,2.7±0.7;p<0.01)、总体疼痛严重程度(基线值3.7±0.5,2.3±0.6,2.3±0.6,2.4±0.6;p<0.01)和疼痛干扰(基线值4.3±0.6,2.4±0.6,2.2±0.6,2.4±0.7,p<0.01)均有统计学意义的下降。ESAS-r疼痛评分在3个月、6个月和9个月随访时显著下降(基线值3.7±0.6,2.5±0.6,2.2±0.6,2.0±0.7,p<0.01)。与以THC为主和以CBD为主的菌株相比,THC:CBD平衡菌株与更好的疼痛缓解相关。在所有随访中均观察到TMB下降。在前三次随访中观察到MEDD下降。

结论

来自这个大型、前瞻性、多中心登记处的真实世界数据表明,MC是癌症患者缓解疼痛的一种安全有效的辅助治疗方法。我们的研究结果应通过随机安慰剂对照试验来证实。

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