J Natl Cancer Inst Monogr (2014) 2014 (50) 346-358.pdf

J Natl Cancer Inst Monogr (2014) 2014 (50) 346-358.pdf

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1、DOI:10.1093/jncimonographs/lgu041?TheAuthor2014.PublishedbyOxfordUniversityPress.Allrightsreserved.ForPermissions,pleasee-mail:journals.permissions@oup.com.ClinicalPracticeGuidelinesontheUseofIntegrativeTherapiesasSupportiveCareinPatientsTreatedforBreastCancerHeather?Greenlee,LyndaG.?Balneav

2、es,LindaE.?Carlson,Misha?Cohen,Gary?Deng,Dawn?Hershman,Matthew?Mumber,Jane?Perlmutter,Dugald?Seely,Ananda?Sen,SuzannaM.?Zick,Debu?Tripathy;fortheSocietyforIntegrativeOncologyGuidelinesWorkingGroupCorrespondenceto:HeatherGreenlee,ND,PhD,MPH,DepartmentofEpidemiology,MailmanSchoolofPublicHealth

3、,ColumbiaUniversity,722W.168thStreet,7thFloor,NewYork,NY10032(e-mail:hg2120@columbia.edu).BackgroundThemajorityofbreastcancerpatientsusecomplementaryand/orintegrativetherapiesduringandbeyondcancertreatmenttomanagesymptoms,preventtoxicities,andimprovequalityoflife.PracticeguidelinesareDownloa

4、dedfromneededtoinformcliniciansandpatientsaboutsafeandeffectivetherapies.MethodsFollowingtheInstituteofMedicine’sguidelinedevelopmentprocess,asystematicreviewidentifiedrandomizedcontrolledtrialstestingtheuseofintegrativetherapiesforsupportivecareinpatientsreceivingbreastcancertreatment.Trial

5、swereincludedifthemajorityofparticipantshadbreastcancerand/orbreastcancerpatienthttp://jncimono.oxfordjournals.org/resultswerereportedseparately,andoutcomeswereclinicallyrelevant.RecommendationswereorganizedbyoutcomeandgradedbaseduponamodifiedversionoftheUSPreventiveServicesTaskForcegradings

6、ystem.ResultsThesearch(January1,1990–December31,2013)?identified4900articles,ofwhich203wereeligibleforanaly-sis.Meditation,yoga,andrelaxationwithimageryarerecommendedforroutineuseforcommonconditions,includinganxietyandmooddisorders(GradeA).Stressmanagement,yoga,massage,musictherapy,energycon

7、servation,andmeditationarerecommendedforstressreduction,anxiety,depression,fatigue,andqualityoflife(GradeB).Manyinterventions(n?=?32)hadweakerevidenceofbenefit(GradeC).Someinterventions(n?=?7)weredeemedunlikelytoprovideanybenefit(GradeD).Notably,on

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