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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
