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Abstract：
Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. © 2017 American Cancer Society.
摘要：
回答问题并获得CME/CNE乳腺癌患者通常在癌症治疗期间使用补充和综合疗法作为支持性护理，并管理与治疗相关的副作用。然而,支持在肿瘤学环境中使用此类疗法的证据有限.本报告提供了综合肿瘤学会关于在乳腺癌治疗期间和之后针对特定临床适应症使用综合疗法的最新临床实践指南。包括焦虑/压力，抑郁症/情绪障碍，疲劳,生活质量/身体功能，化疗引起的恶心和呕吐，淋巴水肿,化疗诱导的周围神经病变，疼痛,和睡眠障碍。临床实践指南基于1990年至2015年的系统文献综述。音乐疗法,冥想，压力管理，和瑜伽被推荐用于焦虑/压力减轻。冥想,放松,瑜伽,按摩,和音乐疗法被推荐用于抑郁症/情绪障碍。建议冥想和瑜伽以改善生活质量。建议使用穴位按摩和针灸来减轻化疗引起的恶心和呕吐。由于可能造成伤害，不建议使用乙酰-L-肉碱预防化疗引起的周围神经病变。没有强有力的证据支持使用摄入的膳食补充剂来管理乳腺癌治疗相关的副作用。总之,越来越多的证据支持使用综合疗法，尤其是身心疗法，作为乳腺癌治疗期间有效的支持性护理策略。许多综合实践，然而,仍然缺乏研究，证据不足，无法明确推荐或避免。CACancerJClin2017；67：194-232。©2017美国癌症协会。
