Li Yongchao, Zhang Wencai, Zeng Xiaochun, Zhou Lu, He Wenjuan, Peng Yadong
Department of Rehabilitation, The First People's Hospital of Chenzhou, Chenzhou, Hunan, China.
Department of Oncology, The First People's Hospital of Chenzhou, Chenzhou, Hunan, China.
Clin Transl Oncol. 2024 Dec 29. doi: 10.1007/s12094-024-03824-7.
Previous studies that evaluated the influence of melatonin supplementation on cancer-related fatigue (CRF) revealed inconsistent results. The present meta-analysis was performed to systematically evaluate the influence of melatonin on the severity of fatigue in patients with cancer.
Relevant randomized controlled trials (RCTs) were acquired by conducting a comprehensive search in the PubMed, Embase, and Cochrane Library databases. Only RCTs published as full-length English-language articles were included. A random-effects model was utilized to combine the findings by incorporating its potential influence.
Nine RCTs were included for the meta-analysis. Compared to the placebo, melatonin supplementation improved the symptoms of fatigue of these patients (standardized mean difference [SMD]: -0.23, 95% confidence interval [CI]: -0.44 to -0.01, p = 0.04, I = 53%). The univariate analysis suggested that the treatment duration was significantly correlated with the improvement of melatonin supplementation on CRF (coefficient = -0.0063, p = 0.02), which largely explains the source of heterogeneity (adjusted R = 83.7%). The subgroup analysis revealed significantly improved fatigue in studies with treatment durations of ≥13 weeks, but not in studies with treatment durations of <13 weeks (SMD: -0.38 vs. 0.06, p for subgroup difference = 0.02). The further subgroup analysis suggested that the results were not significantly influenced by the type of cancer, status (advanced cancer or overall cancer), sample size, treatment (active anticancer treatment or palliative care only), dose of melatonin, or scale for evaluating fatigue symptoms.
Melatonin supplementation may relieve CRF, especially for intervention durations of ≥13 weeks.
既往评估补充褪黑素对癌症相关疲劳（CRF）影响的研究结果并不一致。本荟萃分析旨在系统评价褪黑素对癌症患者疲劳严重程度的影响。
通过全面检索PubMed、Embase和Cochrane图书馆数据库获取相关随机对照试验（RCT）。仅纳入以英文全文发表的RCT。采用随机效应模型合并研究结果，并考虑其潜在影响。
纳入9项RCT进行荟萃分析。与安慰剂相比，补充褪黑素改善了这些患者的疲劳症状（标准化均数差[SMD]：-0.23，95%置信区间[CI]：-0.44至-0.01，p = 0.04，I² = 53%）。单因素分析表明，治疗持续时间与补充褪黑素对CRF的改善显著相关（系数 = -0.0063，p = 0.02），这在很大程度上解释了异质性的来源（调整后R² = 83.7%）。亚组分析显示，治疗持续时间≥13周的研究中疲劳有显著改善，而治疗持续时间<13周的研究中则无改善（SMD：-0.38 vs. 0.06，亚组差异p = 0.02）。进一步的亚组分析表明，结果不受癌症类型、状态（晚期癌症或总体癌症）、样本量、治疗（积极抗癌治疗或仅姑息治疗）、褪黑素剂量或评估疲劳症状的量表的显著影响。
补充褪黑素可能缓解CRF，尤其是干预持续时间≥13周时。
