Cheah Irene, Hunter Jennifer, Gelissen Ingrid, Chan Wai-Jo Jocelin, Harnett Joanna E
School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Health Research Group, Sydney, Australia.
Support Care Cancer. 2024 Dec 18;33(1):40. doi: 10.1007/s00520-024-09087-w.
To summarise the extent and type of evidence in relation to adverse events (AEs) associated with the use of cannabis-based products (CBP) in people living with cancer.
The Joanna Briggs Institute (JBI) methodology for scoping reviews was applied. A search was performed in MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Scopus, Web of Science Core Collections and AMED (Ovid) from their inception to 7 May 2023. Primary studies reporting AEs associated with any form of natural or synthetic CBP use in any cancer care setting and location were included.
One hundred fifty-two studies were included, with the most prevalent being randomised controlled trials (RCTs) (n = 61), followed by non-randomised controlled trials (n = 26) and case reports (n = 23). CBP was mainly used in gastrointestinal, liver, or peritoneal cancer (n = 98) and haematological or lymphoid cancer (n = 92), primarily to manage nausea and vomiting (n = 78) and cancer pain (n = 37). The most common CBP ingredients were combinations of THC and CBD (n = 69), synthetic THC (n = 47), single compounds of THC (n = 42) and CBD (n = 16) with diverse forms, administration routes and doses. The primary methods of administration were oral (n = 94) and inhalation (n = 54). A broad range of AEs were reported; the most common were related to the nervous system (n = 118), psychiatric (n = 101) and gastrointestinal system (n = 81). Diverse patient characteristics, significant under-reporting and low-quality reporting were observed in many studies.
More rigorous research designs that prioritise comprehensive, standardised reporting of AEs and CBP use are required to fully elucidate the safety profile of CBP use in cancer care.
总结与癌症患者使用大麻类产品（CBP）相关的不良事件（AE）的证据范围和类型。
采用乔安娜·布里格斯研究所（JBI）的范围综述方法。在MEDLINE（Ovid）、Embase（Ovid）、CINAHL（EBSCOhost）、Scopus、科学网核心合集和AMED（Ovid）中进行检索，检索时间从各数据库建库至2023年5月7日。纳入在任何癌症护理环境和地点中报告与任何形式天然或合成CBP使用相关的AE的原始研究。
纳入152项研究，其中最常见的是随机对照试验（RCT）（n = 61），其次是非随机对照试验（n = 26）和病例报告（n = 23）。CBP主要用于胃肠道、肝脏或腹膜癌（n = 98）以及血液或淋巴癌（n = 92），主要用于缓解恶心和呕吐（n = 78）以及癌症疼痛（n = 37）。最常见的CBP成分是四氢大麻酚（THC）和大麻二酚（CBD）的组合（n = 69）、合成THC（n = 47）、THC单一化合物（n = 42）和CBD单一化合物（n = 16），其形式、给药途径和剂量各不相同。主要给药方法为口服（n = 94）和吸入（n = 54）。报告了广泛的AE；最常见的与神经系统（n = 118）、精神系统（n = 101）和胃肠道系统（n = 81）有关。在许多研究中观察到不同的患者特征、严重的报告不足和低质量报告。
需要更严格的研究设计，优先对AE和CBP使用进行全面、标准化报告，以充分阐明CBP在癌症护理中使用的安全性概况。
