To present the advances of evidence-based medicine and clinical research methodology in integrative oncology,we conducted a literature review of real-world studies of traditional Chinese medicine(TCM)in cancer care an...To present the advances of evidence-based medicine and clinical research methodology in integrative oncology,we conducted a literature review of real-world studies of traditional Chinese medicine(TCM)in cancer care and summarized the available evidence.Pragmatic randomized controlled trials(pRCTs)and clinical registry studies are becoming more popular as they could compensate for the limitations of RCTs.Many RCTs of TCM for cancer treatment as well as systematic reviews have been published.The most investigated therapies are based on acupuncture,Chinese herbal compounds,and Chinese patent medicines.Acupuncture has a significant advantage in relieving cancer-related symptoms.Published studies focus more on improving clinical symptoms and laboratory indicators.However,the patient's quality of life deserves more attention.展开更多
Western integrative oncology （IO） combines conventional mainstream medicine with complementary and alternative medicine （CAM） for the care of cancer patients. Since it includes patient orientation and the holistic...Western integrative oncology （IO） combines conventional mainstream medicine with complementary and alternative medicine （CAM） for the care of cancer patients. Since it includes patient orientation and the holistic approach of many CAM options, IO offers not only preventive measures, but also a wide spectrum of treatment modalities for all stages of illness, from the acute phases through the rehabilitation period. Many therapeutic methods of IO are supported by scientific evidence, for example, dietary and nutritional counseling, exercise, and mind-body medicine, among others. IO also includes therapeutic interventions of traditional Chinese medicine （TCM）. At present acupuncture, qigong, and foot massage play an important role in the Western care of cancer patients. However, unlike in China, in Western countries herbal remedies are usually only used during those periods in which chemotherapy is not applied in order to avoid herb-drug interactions. Instead,acupuncture is widely used to manage the side-effects that often accompany chemotherapy. This paper focuses on the role of Chinese medicine in Western IO and reviews the scope and limitations of IO in the care of cancer patients today. The future challenges of IO will also be discussed in this paper.展开更多
Music therapy is an integrative oncology practice that has been rapidly emerging,over the past two decades,as a field of its own,clinically and academically.The randomized controlled trials that evaluate the clinical ...Music therapy is an integrative oncology practice that has been rapidly emerging,over the past two decades,as a field of its own,clinically and academically.The randomized controlled trials that evaluate the clinical impact of music therapy are growing in number,and at the same time,there has been progress in understanding the neurobiological mechanisms that underly the beneficial effects of music therapy.Cultural background and autobiographical memories may uniquely influence music perception and cognition.It is vital to personalize music therapy because music preferences are unique;one size does not fit all.Cognitive music science studies and clinical music therapy trials that study individualized music choices will serve as a vital step forward in providing patient-directed personalized integrative cancer care.The field of music therapy is advancing,and its ability to improve a patient’s quality of life can be understood only through robust,personalized,evidence-based initiatives that focus on research,advocacy,education,and delivery of care.展开更多
The basic concept of integrative medicine（IM） is that by combining mainstream（biomedicine） with complementary and alternative medicine（CAM）, synergistic therapeutic effects can be attained.When the methods of mi...The basic concept of integrative medicine（IM） is that by combining mainstream（biomedicine） with complementary and alternative medicine（CAM）, synergistic therapeutic effects can be attained.When the methods of mind/body medicine（MBM） are added to this combination,as in Western countries,a new concept emerges that drastically changes the approach toward illness. It is interesting to note that the joining of traditional Chinese medicine and Western medicine in the early days of the Peoples＇ Republic of China preceded the Western model of IM by almost 50 years.Several elements that make up the key components of IM as practiced today in the West were already present in the Chinese version of IM,and Chinese medicine has played and continues to play an important role in advancing IM.However,one of the major differences between the Chinese and the Western models of IM today,besides MBM and some other treatment options,is that Western integrative medicine（WIM） strictly requires its CAM methods to be supported by scientific evidence. The therapeutic methods of IM and their applications are many and varied.However,they are most frequently employed to treat chronic medical conditions,e.g.,bronchial asthma,rheumatic disease, chronic inflammatory bowel disorder and chronic pain.Other fields in which IM may be applied are internal medicine（inflammatory bowel diseases and cardiovascular diseases）,musculoskeletal disorders,oncology （chemotherapy-induced side effects）,obstetrics and gynecology（dysmenorrhea,endometriosis,infertility and menopausal complaints）,pediatrics,geriatrics,neurology（migraine and chronic headache）,and psychiatry （anxiety and depression）. The concept of WIM is discussed here in detail by reviewing its scope and implications for the practice of medicine and focusing on the role of Chinese medicine in WIM.展开更多
Background:As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms,it is necessary to have a comprehensive assessment on promising intervention to improve pain manageme...Background:As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms,it is necessary to have a comprehensive assessment on promising intervention to improve pain management.Methods:A retrospective study of 489 inpatient cancer patients(1081 visits)was conducted by querying the electronic medical record database to test the reliability and validity of the Edmonton Symptom Assessment System.Data from a pilot prospective randomized controlled study on acupuncture for cancer pain was analyzed to validate the Edmonton Symptom Assessment System(ESAS)as the primary outcome in the integrative oncology research.Results:In the retrospective analysis,scores of the numerical rating scale(NRS)and the ESAS total score were significantly correlated(r=0.15,P=0.02),and the correlation coefficient between NRS and pain sub-scale in ESAS was 0.47(P<0.001).The pilot study showed the proportions of participants experiencing more than a 2-point reduction in NRS at the end of the treatment were 80%(n=12/15)in the acupuncture group and 50%(n=7/14)in the control group,without a significant difference between groups(P=0.13).For the total scores of ESAS,more responders were found in the acupuncture group(n=13/15)compared to that in the control group(n=7/14),with no significant difference between groups(P=0.05).Conclusions:ESAS is suitable for the comprehensive assessment in patients with cancer pain and could be an appropriate outcome measurement in acupuncture research for cancer pain.Trial registration:Registered on 09/07/2018 with ChiCTR1800017023(https://www.chictr/org.cn/edit.aspx?pid=28879&htm=4)展开更多
基金This study was supported by the Key Project of the National Natural Science Foundation of China(81830115).
文摘To present the advances of evidence-based medicine and clinical research methodology in integrative oncology,we conducted a literature review of real-world studies of traditional Chinese medicine(TCM)in cancer care and summarized the available evidence.Pragmatic randomized controlled trials(pRCTs)and clinical registry studies are becoming more popular as they could compensate for the limitations of RCTs.Many RCTs of TCM for cancer treatment as well as systematic reviews have been published.The most investigated therapies are based on acupuncture,Chinese herbal compounds,and Chinese patent medicines.Acupuncture has a significant advantage in relieving cancer-related symptoms.Published studies focus more on improving clinical symptoms and laboratory indicators.However,the patient's quality of life deserves more attention.
文摘Western integrative oncology （IO） combines conventional mainstream medicine with complementary and alternative medicine （CAM） for the care of cancer patients. Since it includes patient orientation and the holistic approach of many CAM options, IO offers not only preventive measures, but also a wide spectrum of treatment modalities for all stages of illness, from the acute phases through the rehabilitation period. Many therapeutic methods of IO are supported by scientific evidence, for example, dietary and nutritional counseling, exercise, and mind-body medicine, among others. IO also includes therapeutic interventions of traditional Chinese medicine （TCM）. At present acupuncture, qigong, and foot massage play an important role in the Western care of cancer patients. However, unlike in China, in Western countries herbal remedies are usually only used during those periods in which chemotherapy is not applied in order to avoid herb-drug interactions. Instead,acupuncture is widely used to manage the side-effects that often accompany chemotherapy. This paper focuses on the role of Chinese medicine in Western IO and reviews the scope and limitations of IO in the care of cancer patients today. The future challenges of IO will also be discussed in this paper.
文摘Music therapy is an integrative oncology practice that has been rapidly emerging,over the past two decades,as a field of its own,clinically and academically.The randomized controlled trials that evaluate the clinical impact of music therapy are growing in number,and at the same time,there has been progress in understanding the neurobiological mechanisms that underly the beneficial effects of music therapy.Cultural background and autobiographical memories may uniquely influence music perception and cognition.It is vital to personalize music therapy because music preferences are unique;one size does not fit all.Cognitive music science studies and clinical music therapy trials that study individualized music choices will serve as a vital step forward in providing patient-directed personalized integrative cancer care.The field of music therapy is advancing,and its ability to improve a patient’s quality of life can be understood only through robust,personalized,evidence-based initiatives that focus on research,advocacy,education,and delivery of care.
文摘The basic concept of integrative medicine（IM） is that by combining mainstream（biomedicine） with complementary and alternative medicine（CAM）, synergistic therapeutic effects can be attained.When the methods of mind/body medicine（MBM） are added to this combination,as in Western countries,a new concept emerges that drastically changes the approach toward illness. It is interesting to note that the joining of traditional Chinese medicine and Western medicine in the early days of the Peoples＇ Republic of China preceded the Western model of IM by almost 50 years.Several elements that make up the key components of IM as practiced today in the West were already present in the Chinese version of IM,and Chinese medicine has played and continues to play an important role in advancing IM.However,one of the major differences between the Chinese and the Western models of IM today,besides MBM and some other treatment options,is that Western integrative medicine（WIM） strictly requires its CAM methods to be supported by scientific evidence. The therapeutic methods of IM and their applications are many and varied.However,they are most frequently employed to treat chronic medical conditions,e.g.,bronchial asthma,rheumatic disease, chronic inflammatory bowel disorder and chronic pain.Other fields in which IM may be applied are internal medicine（inflammatory bowel diseases and cardiovascular diseases）,musculoskeletal disorders,oncology （chemotherapy-induced side effects）,obstetrics and gynecology（dysmenorrhea,endometriosis,infertility and menopausal complaints）,pediatrics,geriatrics,neurology（migraine and chronic headache）,and psychiatry （anxiety and depression）. The concept of WIM is discussed here in detail by reviewing its scope and implications for the practice of medicine and focusing on the role of Chinese medicine in WIM.
基金Supported by the National Natural Science Foundation of China(no.82004447)Guangdong Basic and Applied Basic Research Foundation(no.2021A1515011597)Discipline-Collaborative Innovation Team for"Double First-Class"and High-Level University in Guangzhou University of Chinese Medicine(no.2021XK08)。
文摘Background:As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms,it is necessary to have a comprehensive assessment on promising intervention to improve pain management.Methods:A retrospective study of 489 inpatient cancer patients(1081 visits)was conducted by querying the electronic medical record database to test the reliability and validity of the Edmonton Symptom Assessment System.Data from a pilot prospective randomized controlled study on acupuncture for cancer pain was analyzed to validate the Edmonton Symptom Assessment System(ESAS)as the primary outcome in the integrative oncology research.Results:In the retrospective analysis,scores of the numerical rating scale(NRS)and the ESAS total score were significantly correlated(r=0.15,P=0.02),and the correlation coefficient between NRS and pain sub-scale in ESAS was 0.47(P<0.001).The pilot study showed the proportions of participants experiencing more than a 2-point reduction in NRS at the end of the treatment were 80%(n=12/15)in the acupuncture group and 50%(n=7/14)in the control group,without a significant difference between groups(P=0.13).For the total scores of ESAS,more responders were found in the acupuncture group(n=13/15)compared to that in the control group(n=7/14),with no significant difference between groups(P=0.05).Conclusions:ESAS is suitable for the comprehensive assessment in patients with cancer pain and could be an appropriate outcome measurement in acupuncture research for cancer pain.Trial registration:Registered on 09/07/2018 with ChiCTR1800017023(https://www.chictr/org.cn/edit.aspx?pid=28879&htm=4)
