Kemmner Sarah F, Dörfler Jennifer, Huebner Jutta
Klinik Für Innere Medizin II, Hämatologie Und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, Jena, 07747, Germany.
J Cancer Surviv. 2025 Aug 12. doi: 10.1007/s11764-025-01876-4.
Cannabinoids are compounds that occur naturally in cannabis plants. The objective of this systematic review was to provide an overview of the existing evidence regarding the use of cannabinoids for the management of chemotherapy-induced nausea and vomiting (CINV) in cancer patients.
A systematic literature search was conducted in June 2024 in five electronic databases (Embase, Cochrane, PsychInfo, CINAHL, and Medline) to identify studies examining the utilization, efficacy, and potential adverse effects of cannabinoid-based therapy in cancer patients.
A total of 32 studies comprising 1889 patients suffering from different cancer types were included in the systematic review. Cannabinoid-based therapy involved the oral administration of defined and approved cannabis preparations. Of the 22 studies comparing cannabinoid-based CINV management to now outdated antiemetic therapies, 12 found a significant benefit of cannabinoids in CINV management, and eight out of nine studies comparing cannabinoids to placebo observed such a benefit. Only one of the 32 studies with a risk of bias compared cannabinoids to guideline-based therapy with a 5-HT3 receptor antagonist, an NK1 receptor antagonist, and dexamethasone and demonstrated a benefit of cannabinoids in reducing nausea and vomiting, but the therapy was associated with cannabinoid-related side effects.
With only one study complying with modern antiemetic standards and considering the risks of side effects, clinical evidence to recommend cannabinoids for the management of CINV is deemed insufficient.
Cancer patients suffering from CINV might find alleviation using cannabinoids, but heterogenous results and side effects prevent clinical recommendation.
大麻素是天然存在于大麻植物中的化合物。本系统评价的目的是概述关于使用大麻素治疗癌症患者化疗引起的恶心和呕吐（CINV）的现有证据。
2024年6月在五个电子数据库（Embase、Cochrane、PsychInfo、CINAHL和Medline）中进行了系统的文献检索，以确定研究大麻素类疗法在癌症患者中的应用、疗效和潜在不良反应的研究。
该系统评价共纳入32项研究，涉及1889名患有不同癌症类型的患者。大麻素类疗法包括口服明确且已获批的大麻制剂。在22项将基于大麻素的CINV管理与现已过时的止吐疗法进行比较的研究中，12项发现大麻素在CINV管理中有显著益处，在9项将大麻素与安慰剂进行比较的研究中，有8项观察到了这种益处。在32项存在偏倚风险的研究中，只有1项将大麻素与基于指南的5-HT3受体拮抗剂、NK1受体拮抗剂和地塞米松疗法进行比较，结果显示大麻素在减轻恶心和呕吐方面有好处，但该疗法与大麻素相关的副作用有关。
由于只有一项研究符合现代止吐标准，且考虑到副作用风险，推荐使用大麻素治疗CINV的临床证据被认为不足。
患有CINV的癌症患者可能会通过使用大麻素得到缓解，但结果的异质性和副作用阻碍了临床推荐。
