Department of Pharmacology and Therapeutics, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada.
Cancer. 2023 Nov 15;129(22):3656-3670. doi: 10.1002/cncr.34920. Epub 2023 Aug 28.
Despite the widespread use of medical cannabis, little is known regarding the safety, efficacy, and dosing of cannabis products in children with cancer. The objective of this study was to systematically appraise the existing published literature for the use of cannabis products in children with cancer.
This systematic review, registered with the International Prospective Register of Systematic Reviews (CRD42020187433), searched four databases: MEDLINE, Embase, PsycINFO, and the Cochrane Library. Abstracts and full texts were screened in duplicate. Data on types of cannabis products, doses, formulations, frequencies, routes of administration, indications, and clinical and demographic details as well as reported efficacy outcomes were extracted. Data on cannabinoid-related adverse events were also summarized.
Out of 34,611 identified citations, 19 unique studies with a total of 1927 participants with cancer were included: eight retrospective chart reviews, seven randomized controlled trials, two open-label studies, and two case reports. The included studies reported the use of various cannabis products for the management of symptoms. Cannabinoids were commonly used for the management of chemotherapy-induced nausea and vomiting (11 of 19 [58%]). In controlled studies, somnolence, dizziness, dry mouth, and withdrawal due to adverse events were more commonly associated with the use of cannabinoids. Across all included studies, no serious cannabis-related adverse events were reported.
Although there is evidence to support the use of cannabis for symptom management, in children with cancer, there is a lack of rigorous evidence to inform the dosing, safety, and efficacy of cannabinoids. Because of the increasing interest in using cannabis, there is an urgent need for more research on medical cannabis in children with cancer.
尽管医用大麻的应用已经非常广泛，但人们对于癌症患儿使用大麻制品的安全性、疗效和剂量仍知之甚少。本研究旨在系统评估现有关于癌症患儿使用大麻制品的文献。
本系统评价已在国际前瞻性系统评价登记处（CRD42020187433）注册，检索了 MEDLINE、Embase、PsycINFO 和 Cochrane 图书馆这四个数据库。对摘要和全文进行了重复筛选。提取了有关大麻制品类型、剂量、剂型、频率、给药途径、适应证以及临床和人口统计学细节以及报告的疗效结果的数据。还总结了与大麻素相关的不良事件的数据。
在 34611 篇已识别文献中，有 19 项独特的研究共纳入了 1927 名癌症患儿：8 项回顾性图表审查、7 项随机对照试验、2 项开放标签研究和 2 项病例报告。这些研究报告了使用各种大麻制品来控制症状。大麻素常用于治疗化疗引起的恶心和呕吐（19 项研究中的 11 项[58%]）。在对照研究中，与使用大麻素相关的不良事件更常见的是嗜睡、头晕、口干和因不良反应而停药。在所有纳入的研究中，均未报告严重的与大麻相关的不良事件。
尽管有证据支持大麻用于症状管理，但在癌症患儿中，关于大麻素的剂量、安全性和疗效的严格证据仍然缺乏。由于对使用大麻的兴趣日益增加，迫切需要对癌症患儿的医用大麻进行更多的研究。
