Scientific research has brought about enormous national advancements in cancer management. Currently, Morocco provides several therapeutic tools for cancer, among them chemotherapy, surgery and radiotherapy. In Morocc...Scientific research has brought about enormous national advancements in cancer management. Currently, Morocco provides several therapeutic tools for cancer, among them chemotherapy, surgery and radiotherapy. In Morocco, there is not enough published data on the use of alternative medicine in pediatric oncology. Owing to the increased interest and lack of data on this practice, we conducted this study. It aims to evaluate the uptake, the types of therapies used, the factors influencing, the reasons for this choice and the cost of AM used by patients. An investigation through a questionnaire was carried out on thirty-four children following for cancer within the pediatric hematology and oncology department (PHO) of Marrakech. The survey was conducted over a period of one month and a half between July 25 and September 5, 2022. Data were collected through a questionnaire. From the medical files, we collected data regarding type of cancer, date of admission to PHO department and the treatment received. We asked about the type of AM used: herbs, honey, spiritual AM, zamzam water (water from a “sacred” source in Mecca). Using alternative therapies is a common practice in pediatric oncology with various reasons, among them, the declining socioeconomic level, the diversity, the cultural background, the psychological and the functional status of patients and sometimes the dissatisfaction with conventional medicine.展开更多
目的:采用网状Meta分析综合比较10种口服中成药联合化疗治疗胃癌的疗效和安全性。方法:计算机检索PubMed,Embase,Web of Science,Cochrane Library,中国知网、中国生物医学文献服务系统、维普网、万方数据库,检索时间为建库至2020年3月...目的:采用网状Meta分析综合比较10种口服中成药联合化疗治疗胃癌的疗效和安全性。方法:计算机检索PubMed,Embase,Web of Science,Cochrane Library,中国知网、中国生物医学文献服务系统、维普网、万方数据库,检索时间为建库至2020年3月1日。对纳入的随机对照试验(RCT)进行筛选、提取数据和便宜风险评价。然后采用RevMan 5.3软件进行Meta分析,ADDIS 1.16.7进行网状Meta分析。结果:共纳入41项随机对照研究,均为双臂,包含10种口服中成药,分析结果显示,与单纯化疗相比,华蟾素,金龙胶囊,平消胶囊,参一胶囊,消癌平片,西黄丸(或胶囊),养正消积胶囊,贞芪扶正颗粒联合化疗治疗胃癌的有效率明显提高(P<0.05),贞芪扶正+化疗方案排序最高;华蟾素、参一胶囊、养正消积胶囊、贞芪扶正颗粒联合化疗治疗胃癌的KPS改善率明显提高(P<0.05),参一胶囊+化疗方案为最优;金龙胶囊、养正消积联合化疗能明显降低恶心呕吐的发生率(P<0.05),华蟾素联合化疗治疗胃癌的白细胞下降发生率明显降低(P<0.05),贞芪扶正颗粒为最佳;各中成药均不能降低神经毒性发病率;华蟾素、养正消积胶囊、贞芪扶正颗粒联合化疗治疗可提升胃癌患者血液中CD4+/CD8+(P<0.05)。结论:口服中成药联合化疗治疗胃癌在各方面发挥优势,贞芪扶正颗粒、养正消积胶囊、参一胶囊对生存改善、降低不良反应有较好的疗效。展开更多
Liver metastasis is the commonest form of distant metastasis in colorectal cancer.Selection criteria for surgery and liver-directed therapies have recently been extended.However,resectability remains poorly defined.Tu...Liver metastasis is the commonest form of distant metastasis in colorectal cancer.Selection criteria for surgery and liver-directed therapies have recently been extended.However,resectability remains poorly defined.Tumour biology is increasingly recognized as an important prognostic factor;hence molecular profiling has a growing role in risk stratification and management planning.Surgical resection is the only treatment modality for curative intent.The most appropriate surgical approach is yet to be established.The primary cancer and the hepatic metastasis can be removed simultaneously or in a two-step approach;these two strategies have comparable long-term outcomes.For patients with a limited future liver remnant,portal vein embolization,combined ablation and resection,and associating liver partition and portal vein ligation for staged hepatectomy have been advocated,and each has their pros and cons.The role of neoadjuvant and adjuvant chemotherapy is still debated.Targeted biological agents and loco-regional therapies(thermal ablation,intra-arterial chemo-or radio-embolization,and stereotactic radiotherapy) further improve the already favourable results.The recent debate about offering liver transplantation to highly selected patients needs validation from large clinical trials.Evidencebased protocols are missing,and therefore optimal management of hepatic metastasis should be personalized and determined by a multi-disciplinary team.展开更多
Objective： To evaluate the effectiveness of Shenqi Fuzheng Injection （参芪扶正注射液, SFI） combined with chemotherapy for advanced gastric cancer. Methods： Randomized controlled trials （RCTs） from 10 databases w...Objective： To evaluate the effectiveness of Shenqi Fuzheng Injection （参芪扶正注射液, SFI） combined with chemotherapy for advanced gastric cancer. Methods： Randomized controlled trials （RCTs） from 10 databases were searched for this meta-analysis till December 31, 2012 without language restriction. Grey literature and potential unpublished literature was also searched. The key search terms were ＂chemotherapy＂, ＂Shenqi Fuzheng Injection＂ and ＂advanced gastric cancer＂. Criteria were built to select these clinical trials, in which SFI combined with chemotherapy was compared with chemotherapy alone for advanced gastric cancer. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. RevMan 5.1 software was applied for data analyses. Results： Thirteen RCTs involving 860 patients met the selection criteria （all articles were from Chinese databases）. The meta-analysis showed positive results for the use of SFI combined with chemotherapy according to quality of life in terms of the scores when compared with chemotherapy alone. Positive results were also obtained for the combination treatment, in terms of complete remission and partial remission efficacy rate, body weight and decreased adverse events including nausea and vomiting at grade 3-4, oral mucositis at grade 1-2, leucopenia at grade 3-4, and myelo-suppression at grade 1-2. Conclusions： This systematic review found encouraging albeit limited evidence for SFI combined with chemotherapy. However, to obtain stronger evidence without the drawbacks of trial design and the quality of studies, we recommend comparative effectiveness researches to test the effectiveness of combination treatment.展开更多
文摘Scientific research has brought about enormous national advancements in cancer management. Currently, Morocco provides several therapeutic tools for cancer, among them chemotherapy, surgery and radiotherapy. In Morocco, there is not enough published data on the use of alternative medicine in pediatric oncology. Owing to the increased interest and lack of data on this practice, we conducted this study. It aims to evaluate the uptake, the types of therapies used, the factors influencing, the reasons for this choice and the cost of AM used by patients. An investigation through a questionnaire was carried out on thirty-four children following for cancer within the pediatric hematology and oncology department (PHO) of Marrakech. The survey was conducted over a period of one month and a half between July 25 and September 5, 2022. Data were collected through a questionnaire. From the medical files, we collected data regarding type of cancer, date of admission to PHO department and the treatment received. We asked about the type of AM used: herbs, honey, spiritual AM, zamzam water (water from a “sacred” source in Mecca). Using alternative therapies is a common practice in pediatric oncology with various reasons, among them, the declining socioeconomic level, the diversity, the cultural background, the psychological and the functional status of patients and sometimes the dissatisfaction with conventional medicine.
文摘Liver metastasis is the commonest form of distant metastasis in colorectal cancer.Selection criteria for surgery and liver-directed therapies have recently been extended.However,resectability remains poorly defined.Tumour biology is increasingly recognized as an important prognostic factor;hence molecular profiling has a growing role in risk stratification and management planning.Surgical resection is the only treatment modality for curative intent.The most appropriate surgical approach is yet to be established.The primary cancer and the hepatic metastasis can be removed simultaneously or in a two-step approach;these two strategies have comparable long-term outcomes.For patients with a limited future liver remnant,portal vein embolization,combined ablation and resection,and associating liver partition and portal vein ligation for staged hepatectomy have been advocated,and each has their pros and cons.The role of neoadjuvant and adjuvant chemotherapy is still debated.Targeted biological agents and loco-regional therapies(thermal ablation,intra-arterial chemo-or radio-embolization,and stereotactic radiotherapy) further improve the already favourable results.The recent debate about offering liver transplantation to highly selected patients needs validation from large clinical trials.Evidencebased protocols are missing,and therefore optimal management of hepatic metastasis should be personalized and determined by a multi-disciplinary team.
文摘Objective： To evaluate the effectiveness of Shenqi Fuzheng Injection （参芪扶正注射液, SFI） combined with chemotherapy for advanced gastric cancer. Methods： Randomized controlled trials （RCTs） from 10 databases were searched for this meta-analysis till December 31, 2012 without language restriction. Grey literature and potential unpublished literature was also searched. The key search terms were ＂chemotherapy＂, ＂Shenqi Fuzheng Injection＂ and ＂advanced gastric cancer＂. Criteria were built to select these clinical trials, in which SFI combined with chemotherapy was compared with chemotherapy alone for advanced gastric cancer. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. RevMan 5.1 software was applied for data analyses. Results： Thirteen RCTs involving 860 patients met the selection criteria （all articles were from Chinese databases）. The meta-analysis showed positive results for the use of SFI combined with chemotherapy according to quality of life in terms of the scores when compared with chemotherapy alone. Positive results were also obtained for the combination treatment, in terms of complete remission and partial remission efficacy rate, body weight and decreased adverse events including nausea and vomiting at grade 3-4, oral mucositis at grade 1-2, leucopenia at grade 3-4, and myelo-suppression at grade 1-2. Conclusions： This systematic review found encouraging albeit limited evidence for SFI combined with chemotherapy. However, to obtain stronger evidence without the drawbacks of trial design and the quality of studies, we recommend comparative effectiveness researches to test the effectiveness of combination treatment.
