MASCC guideline: cannabis for cancer-related pain and risk of harms and adverse events

被引:28
作者
To, Josephine [1 ]
Davis, Mellar [2 ]
Sbrana, Andrea [3 ]
Alderman, Bryony [4 ]
Hui, David [5 ]
Mukhopadhyay, Sandip [6 ]
Bouleuc, Carole [7 ]
Case, Amy A. A. [8 ,9 ]
Amano, Koji [10 ]
Crawford, Gregory P. P. [11 ]
de Feo, Giulia [12 ]
Tanco, Kimberson [5 ]
Garsed, Jessica [13 ]
机构
[1] Northern Adelaide Local Hlth Network, Div Aged Care Rehabil & Palliat Care, Adelaide, Australia
[2] Geisinger Med Syst, Palliat Care Dept, Danville, PA 17821 USA
[3] Univ Pisa, Pisa, Italy
[4] Frimley Pk Hosp, Frimley, England
[5] Univ Texas MD Anderson Canc Ctr, Dept Palliat Care Rehabil & Integrat Med, Houston, TX USA
[6] Indian Council Med Res, New Delhi, India
[7] PSL Univ, Inst Curie, Dept Support & Palliat Care, Paris, France
[8] Roswell Park Comprehens Canc Ctr, Buffalo, NY USA
[9] Univ Buffalo, Div Geriatr & Palliat Med, Jacobs Sch Med & Biomed Sci, Buffalo, NY USA
[10] Natl Canc Ctr, Dept Palliat Med, Tokyo, Japan
[11] Univ Adelaide, Fac Hlth & Med Sci, Northern Adelaide Local Hlth Network, Adelaide, SA, Australia
[12] Inst Nazl Tumori, Milan, Italy
[13] Geisinger Med Ctr, Danville, PA USA
关键词
Adverse events; Cannabinoids; Cancer; OPIOID RECEPTOR AGONISTS; CHEMOTHERAPY-INDUCED NAUSEA; DOUBLE-BLIND; RHESUS-MONKEYS; ADJUNCTIVE THERAPY; OROMUCOSAL SPRAY; CLINICAL-TRIALS; QUALITY; DISCRIMINATION; SENSITIZATION;
D O I
10.1007/s00520-023-07662-1
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundApproximately 18% of patients with cancer use cannabis at one time as palliation or treatment for their cancer. We performed a systematic review of randomized cannabis cancer trials to establish a guideline for its use in pain and to summarize the risk of harm and adverse events when used for any indication in cancer patients.MethodsA systematic review of randomized trials with or without meta-analysis was carried out from MEDLINE, CCTR, Embase, and PsychINFO. The search involved randomized trials of cannabis in cancer patients. The search ended on November 12, 2021. The Jadad grading system was used for grading quality. Inclusion criteria for articles were randomized trials or systematic reviews of randomized trials of cannabinoids versus either placebo or active comparator explicitly in adult patients with cancer.ResultsThirty-four systematic reviews and randomized trials met the eligibility criteria for cancer pain. Seven were randomized trials involving patients with cancer pain. Two trials had positive primary endpoints, which could not be reproduced in similarly designed trials. High-quality systematic reviews with meta-analyses found little evidence that cannabinoids are an effective adjuvant or analgesic to cancer pain. Seven systematic reviews and randomized trials related to harms and adverse events were included. There was inconsistent evidence about the types and levels of harm patients may experience when using cannabinoids.ConclusionThe MASCC panel recommends against the use of cannabinoids as an adjuvant analgesic for cancer pain and suggests that the potential risk of harm and adverse events be carefully considered for all cancer patients, particularly with treatment with a checkpoint inhibitor.
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页数:17
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