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Examining patterns of traditional chinese medicine use in pediatric oncology: A systematic review, meta-analysis and data-mining study

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Journal of Integrative Medicine 2022年第5期20卷 402-415页

作者： Chun Sing Lam Li Wen Peng Lok Sum Yang Ho Wing Janessa Chou Chi-Kong Li Zhong Zuo Ho-Kee Koon Yin Ting Cheung School of Pharmacy Faculty of Medicinethe Chinese University of Hong KongHong KongChina Department of Paediatrics Faculty of Medicinethe Chinese University of Hong KongHong KongChina Hong Kong Hub of Paediatric Excellence the Chinese University of Hong KongHong KongChina Department of Paediatrics&Adolescent Medicine Hong Kong Children’s HospitalHong KongChina School of Chinese Medicine Faculty of Medicinethe Chinese University of Hong KongHong KongChina

Background Traditional Chinese medicine(TCM)is becoming a popular complementary approach in pediatric oncology.However,few or no meta-analyses have focused on clinical studies of the use of TCM in pediatric oncology.Objective We explored the patterns of TCM use and its efficacy in children with cancer,using a systematic review,meta-analysis and data mining study.Search strategy We conducted a search of five English(Allied and Complementary Medicine Database,Embase,PubMed,Cochrane Central Register of Controlled Trials,and ClinicalTrials.gov)and four Chinese databases(Wanfang Data,China National Knowledge Infrastructure,Chinese Biomedical Literature Database,and VIP Chinese Science and Technology Periodicals Database)for clinical studies published before October 2021,using keywords related to“pediatric,”“cancer,”and“TCM.”Inclusion criteria We included studies which were randomized controlled trials(RCTs)or observational clinical studies,focused on patients aged<19 years old who had been diagnosed with cancer,and included at least one group of subjects receiving TCM treatment.Data extraction and analysis The methodological quality of RCTs and observational studies was assessed using the six-item Jadad scale and the Effective Public Healthcare Panacea Project Quality Assessment Tool,respectively.Meta-analysis was used to evaluate the efficacy of combining TCM with chemotherapy.Study outcomes included the treatment response rate and occurrence of cancer-related symptoms.Association rule mining(ARM)was used to investigate the associations among medicinal herbs and patient symptoms.Results The fifty-four studies included in this analysis were comprised of RCTs(63.0%)and observational studies(37.0%).Most RCTs focused on hematological malignancies(41.2%).The study outcomes included chemotherapy-induced toxicities(76.5%),infection rate(35.3%),and response,survival or relapse rate(23.5%).The methodological quality of most of the RCTs(82.4%)and observational studies(80.0%)was rated as“moderate.”In studies of leukemia patient

关键词： Traditional Chinese Medicine Herbal medicine pediatric oncology Data mining Associate rule mining Chemotherapy

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Neutropenic enterocolitis in pediatric leukemia patients treated with intensive chemotherapy in Upper Egypt

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pediatric Investigation 2020年第1期4卷 5-10页

作者： Ereen Refaat Fouad Ahmed Mohammed Morsy Hosam Eldein Mostafa Kamel Amany Mohamed Ali Department of pediatric oncology South Egypt Cancer InstituteAssiut UniversityAssiutEgypt Department of Radiology South Egypt Cancer InstituteAssiut UniversityAssiutEgypt

Importance: In low resource countries, there has been scarcity of research on the risk factors associated with neutropenic enterocolitis, a serious complication that commonly develops during treatment of cancer patients.Objective: To identify the pattern of intestinal complications in pediatric leukemia patients treated with intensive chemotherapy, including those with neutropenic enterocolitis;to assess the outcome;and to evaluate the risk factors associated with the mortality in these patients.Methods: During the period from June 2015 to December 2016, a prospective study was carried out on pediatric patients diagnosed with acute leukemia who received induction/or re-induction phases of chemotherapy at South Egypt Cancer Institute. Patients with documented episodes of intestinal complications were included in the study. Recovery or death from an episode of intestinal complication was utilized as the primary outcome measure for the study. Using univariable and multivariable methods, potential risk factors associated with mortality were delineated by logistic regression analysis, both for the entire intestinal complications episodes as a whole and for those episodes of neutropenic enterocolitis only.Results: Out of 88 documented episodes of intestinal complications from 77 patients;58 episodes were identified as neutropenic enterocolitis from 47 patients. In those patients who were having episodes of neutropenic enterocolitis, the presence of abdominal tenderness (OR 4.529, 95%CI 1.062-19.317,P = 0.041);a longer duration of neutropenia (OR 1.215, 95%CI 1.030-1.434,P = 0.021);and hemodynamic instability (OR 17.023, 95%CI 4.095-70.772,P < 0.001), were found to be independently associated with worse outcome.Interpretation: In Upper Egypt, the use of intensive systemic chemotherapy during the induction phase of acute leukemia was found to be associated with potentially lethal intestinal complications. A high index of clinical suspicion is warranted.

关键词： Neutropenic enterocolitis Acute leukemia Induction chemotherapy Intestinal complication pediatric oncology

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