Indications of Cannabinoids for the Palliation of Cancer-Associated Symptoms: A Systematic Review and Meta-Analysis.

IF 5 2区医学 Q1 ONCOLOGY

Current Oncology Reports Pub Date : 2025-09-01 Epub Date: 2025-08-01 DOI:10.1007/s11912-025-01695-x

Ioana Creangă-Murariu, Ioana-Irina Rezuș, Roshanak Karami, Anett Rancz, Ádám Zolcsák, Marie Anne Engh, Mahmoud Obeidat, Bogdan-Ionel Tamba, Péter Hegyi, Stefania Bunduc

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引用次数: 0

Abstract

Purpose of the review: As cancer survival rates are increasing, alternative treatments to improve quality of life, such as cannabinoids, are gaining attention. Although cannabinoids are widely used to manage cancer-related symptoms, clear guidelines are lacking. This systematic review and meta-analysis assessed the safety and efficacy of cannabinoids in the management of symptoms among cancer patients. The study protocol was registered on PROSPERO (CRD42023479375). A systematic search was conducted using three main databases (PubMed, Embase, and CENTRAL) on 4 November 2023. We included interventional and observational studies that evaluated cannabinoids for symptom management in cancer patients compared to standard care, placebo, or baseline values. Pooled mean differences (MD), proportions and odds ratios (OR), and the 95% confidence intervals (CI) were calculated with a random-effects model.

Recent findings: Overall, 98 articles were eligible. Cannabinoids reduced pain (MRAW: -1.22, CI: -1.92; -0.52) and anxiety (MRAW: -1.30, CI: -2.22; -0.39) as compared to baseline values. Appetite (MRAW: -1.88, CI: -6.23; 2.46), chemotherapy-induced nausea and vomiting (OR: 2.18, CI: 0.79; 6.00), as well as insomnia (MD: -1.08, CI: -2.48; 0.33) presented with a tendency toward improvement. Cannabinoids do not influence constipation, depression, fatigue, mobility or overall quality of life. In terms of safety issues, THC-predominant formulations increase the risks of psychiatric (OR: 10.62, CI: 1.35; 83.57), neurological (OR:2.24, CI: 1.15; 4.35), and gastrointestinal (OR:2.69, CI:0.73;9.90) side effects. The risk of bias of articles included varied from some concerns to high. Cannabinoids may be beneficial for the treatment of cancer-related pain and anxiety; however, their use carries a significant risk of adverse effects, particularly psychiatric complications. Careful patient selection is essential when considering cannabinoid-based treatments.

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大麻素缓解癌症相关症状的适应症：系统回顾和荟萃分析

综述目的：随着癌症存活率的增加，大麻素等替代治疗方法正在引起人们的关注，以提高生活质量。虽然大麻素被广泛用于治疗癌症相关症状，但缺乏明确的指导方针。本系统综述和荟萃分析评估了大麻素治疗癌症患者症状的安全性和有效性。研究方案已在PROSPERO上注册（CRD42023479375）。于2023年11月4日使用三个主要数据库（PubMed、Embase和CENTRAL）进行了系统检索。我们纳入了与标准治疗、安慰剂或基线值相比，评估大麻素对癌症患者症状管理的干预性和观察性研究。采用随机效应模型计算合并平均差异（MD）、比例和优势比（OR）以及95%置信区间（CI）。最近的发现：总共有98篇文章符合条件。大麻素减轻疼痛(MRAW: -1.22, CI: -1.92；-0.52)和焦虑(MRAW: -1.30, CI: -2.22；-0.39)，与基线值相比。食欲(MRAW: -1.88, CI: -6.23；2.46)，化疗引起的恶心和呕吐(OR: 2.18, CI: 0.79；6.00)，失眠(MD: -1.08, CI: -2.48；[0.33]呈现出改善的趋势。大麻素不会影响便秘、抑郁、疲劳、行动能力或整体生活质量。就安全性问题而言，以四氢大麻酚为主的制剂增加了精神疾病的风险(OR: 10.62, CI: 1.35；83.57)，神经学(OR:2.24, CI: 1.15；4.35)和胃肠道副作用（OR:2.69, CI:0.73;9.90）。纳入的文章的偏倚风险从一些关注到高不等。大麻素可能有助于治疗癌症相关的疼痛和焦虑；然而，它们的使用有很大的副作用风险，特别是精神并发症。在考虑以大麻素为基础的治疗时，仔细选择患者是必不可少的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Oncology Reports ONCOLOGY-

CiteScore

8.50

自引率

0.00%

发文量

187

审稿时长

6-12 weeks

期刊介绍： This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.