背景:尽管医用大麻的广泛使用,对安全性知之甚少,功效,和给癌症儿童服用大麻产品。这项研究的目的是系统地评估现有的已发表文献,以将大麻产品用于癌症儿童。
方法:本系统综述,在国际前瞻性系统审查登记册(CRD42020187433)注册,搜索了四个数据库:MEDLINE,Embase,PsycINFO,还有Cochrane图书馆.摘要和全文一式两份进行筛选。关于大麻产品类型的数据,剂量,配方,频率,管理路线,适应症,并提取临床和人口统计学细节以及报告的疗效结局.还总结了大麻素相关不良事件的数据。
结果:在34,611个确定的引文中,包括19项独特研究,共1927名癌症参与者:8项回顾性图表回顾,7项随机对照试验,两项开放标签研究,和两个病例报告。纳入的研究报告了使用各种大麻产品来控制症状。大麻素通常用于治疗化疗引起的恶心和呕吐(19个中的11个[58%])。在对照研究中,嗜睡,头晕,口干,和因不良事件而停药更常见与大麻素的使用相关.在所有纳入的研究中,未报告与大麻相关的严重不良事件.
结论:尽管有证据支持将大麻用于症状管理,在患有癌症的儿童中,缺乏严格的证据来告知剂量,安全,和大麻素的功效。由于人们对使用大麻的兴趣日益浓厚,迫切需要对癌症儿童中的医用大麻进行更多的研究。
Despite the widespread use of medical cannabis, little is known regarding the safety, efficacy, and dosing of cannabis products in children with cancer. The objective of this study was to systematically appraise the existing published literature for the use of cannabis products in children with cancer.
This systematic
review, registered with the International Prospective Register of Systematic Reviews (CRD42020187433), searched four databases: MEDLINE, Embase, PsycINFO, and the Cochrane Library. Abstracts and full texts were screened in duplicate. Data on types of cannabis products, doses, formulations, frequencies, routes of administration, indications, and clinical and demographic details as well as reported efficacy outcomes were extracted. Data on cannabinoid-related adverse events were also summarized.
Out of 34,611 identified citations, 19 unique studies with a total of 1927 participants with cancer were included: eight retrospective chart reviews, seven randomized controlled trials, two open-label studies, and two case reports. The included studies reported the use of various cannabis products for the management of symptoms. Cannabinoids were commonly used for the management of chemotherapy-induced nausea and vomiting (11 of 19 [58%]). In controlled studies, somnolence, dizziness, dry mouth, and withdrawal due to adverse events were more commonly associated with the use of cannabinoids. Across all included studies, no serious cannabis-related adverse events were reported.
Although there is evidence to support the use of cannabis for symptom management, in children with cancer, there is a lack of rigorous evidence to inform the dosing, safety, and efficacy of cannabinoids. Because of the increasing interest in using cannabis, there is an urgent need for more research on medical cannabis in children with cancer.