Resumen de la ponencia


Dr. S. Abanades

Introduction

The use of complementary therapies in oncology has dramatically increased during the last years. However, the level of scientific evidence in this area is uncertain and still face important controversies.

Methodology

A data analysis and extraction of evidence and recommendations by levels of evidence from the "Clinical practice guidelines based on systematic reviews of the literature" of the "Society of Integrative Oncology" was performed. Additional search was expanded in Pubmed limited to: "systematic reviews" "meta-analysis" up to September 2017.

Results

Evidence-based clinical practice guidelines recommend acupuncture for poorly controlled pain and post chemotherapy nausea and vomiting (1A) and xerostomia (1B). In the management of the stress of the oncological patient "Mind and body techniques" through a multidisciplinary approach are recommended to reduce anxiety, mood disorders, pain and increase quality of life (1A). Regarding the additional search for systematic reviews and meta-analyzes up to 2017: There is evidence of the highest level that comes from systematic reviews and meta-analysis of randomized and controlled clinical trials for:

-Acupuncture: post-chemotherapy nausea and vomiting, xerostomia, pain and fatigue and arthralgia for aromatase inhibitors in breast cancer

-Mindfulness/meditation: stress, anxiety, mood disorders, pain and quality of life

-Yoga: fatigue, stress, anxiety, mood disorders, pain and quality of life

-Probiotics: diarrhoea during chemotherapy/RT, intestinal barrier maintenance, prevention of postoperative infection

-Vitamin D: infra-therapeutic levels vitamin D associated with decreased survival (breast and lung cancer)

-Vitamin E topical: oral mucositis after radiotherapy and/ or chemotherapy

-L-Glutamine: mucositis post RT / chemotherapy and decreases stay and infectious complications in enteral nutrition

-Reishi Ganoderma lucidum: Improves immunity as a complement to chemotherapy / RT

-Omega-3 fatty acids: ensure weight maintenance in enteral nutrition

Conclusions and evidence-based recommendations

-There are several complementary therapies with evidence of efficacy and safety derived from meta-analysis in oncology.

-Complementary therapies with the highest level of evidence should be incorporated without delay into the integrated treatment of cancer patients

-Information should be provided (based on scientific evidence) to facilitate the training of the oncology team to promote an integral treatment of the cancer patient.