Krisstina Gowin, Meri Muminovic, Suzanna M Zick, Richard T Lee, Christina Lacchetti, Ashwin Mehta
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Panel members reviewed each trial for quality of evidence, determined a grade quality assessment label, and concluded strength of recommendations.</p><p><strong>Results: </strong>Strong recommendations for management of cancer fatigue during treatment were given to both in-person or web-based mindfulness-based stress reduction, mindfulness-based cognitive therapy, and tai chi or qigong. Strong recommendations for management of cancer fatigue after cancer treatment were given to mindfulness-based programs. Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial. The recommended modalities for managing anxiety included Mindfulness-Based Interventions (MBIs), yoga, hypnosis, relaxation therapies, music therapy, reflexology, acupuncture, tai chi, and lavender essential oils. 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引用次数: 0
摘要
导言:美国癌症协会(ASCO)和中西医结合肿瘤学会(Society for Integrative Oncology)合作制定了癌症患者应用中西医结合方法治疗焦虑、抑郁、疲劳以及使用大麻素和大麻的指南。这些指南提供了以证据为基础的建议,通过综合方法加强常规癌症治疗,从而提高治疗效果和生活质量:专家小组由一名患者权益倡导者、一名 ASCO 方法学专家、肿瘤治疗提供者和综合医学专家组成。专家组成员审查了每项试验的证据质量,确定了质量评估等级标签,并得出了建议强度结论:对于治疗期间的癌症疲劳管理,强烈建议采用现场或网络正念减压疗法、正念认知疗法以及太极拳或气功。对于癌症治疗后的癌症疲劳管理,基于正念的项目获得了强烈推荐。除非是在临床试验的背景下,否则临床医生应建议不要将大麻或大麻素用作癌症导向治疗。推荐的焦虑管理模式包括正念干预(MBIs)、瑜伽、催眠、放松疗法、音乐疗法、反射疗法、针灸、太极拳和薰衣草精油。指南中最强烈的建议是,应在积极治疗期间和治疗后为癌症患者提供 MBIs,以解决抑郁问题:癌症护理中综合干预的证据越来越多,目前的研究支持综合干预在整个癌症护理过程中的益处。
Integrative Therapies in Cancer Care: An Update on the Guidelines.
Introduction: ASCO and the Society for Integrative Oncology have collaborated to develop guidelines for the application of integrative approaches in the management of anxiety, depression, fatigue and use of cannabinoids and cannabis in patients with cancer. These guidelines provide evidence-based recommendations to improve outcomes and quality of life by enhancing conventional cancer treatment with integrative modalities.
Methods: All studies that informed the guideline recommendations were reviewed by an Expert Panel which was made up of a patient advocate, an ASCO methodologist, oncology providers, and integrative medicine experts. Panel members reviewed each trial for quality of evidence, determined a grade quality assessment label, and concluded strength of recommendations.
Results: Strong recommendations for management of cancer fatigue during treatment were given to both in-person or web-based mindfulness-based stress reduction, mindfulness-based cognitive therapy, and tai chi or qigong. Strong recommendations for management of cancer fatigue after cancer treatment were given to mindfulness-based programs. Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial. The recommended modalities for managing anxiety included Mindfulness-Based Interventions (MBIs), yoga, hypnosis, relaxation therapies, music therapy, reflexology, acupuncture, tai chi, and lavender essential oils. The strongest recommendation in the guideline is that MBIs should be offered to people with cancer, both during active treatment and post-treatment, to address depression.
Conclusion: The evidence for integrative interventions in cancer care is growing, with research now supporting benefits of integrative interventions across the cancer care continuum.
期刊介绍:
The Ed Book is a National Library of Medicine–indexed collection of articles written by ASCO Annual Meeting faculty and invited leaders in oncology. Ed Book was launched in 1985 to highlight standards of care and inspire future therapeutic possibilities in oncology. Published annually, each volume highlights the most compelling research and developments across the multidisciplinary fields of oncology and serves as an enduring scholarly resource for all members of the cancer care team long after the Meeting concludes. These articles address issues in the following areas, among others: Immuno-oncology, Surgical, radiation, and medical oncology, Clinical informatics and quality of care, Global health, Survivorship.