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Complementary and Alternative Medicine for the Treatment of Gliomas: Scoping Review of Clinical Studies, Patient Outcomes, and Toxicity Profiles.

World neurosurgery
July 1, 2021
Dhiraj J Pangal et al. (10 authors)
Journal ArticleScoping ReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effects of antioxidants on survival outcomes in patients with newly diagnosed or recurrent glioma.

Results Summary

Antioxidant usage showed mixed results, with potential benefits more pronounced in low-grade gliomas; vitamin D intake was associated with prolonged survival.

Population

Patients with low- and high-grade glioma.

Effective Dosage

Not available

Duration

Not specified

Interactions

None mentioned

Extracted Claims (19)
InterventionDirectionEndpointPopulationDosageImpactClaim #
ketogenic diet
no change
safety and tolerability
patients with glioma
-
appear to be safe and well tolerated
#1
ketogenic diet
decrease
tumor response
patients with glioma
-
demonstrate tumor response
#2
ketogenic diet
increase
progression-free survival
patients with glioma
-
increased progression-free survival
#3
ketogenic diet
increase
overall survival
patients with glioma
-
increased overall survival
#4
hyperbaric oxygen therapy
no change
safety and tolerability
patients with glioma
-
appear to be safe and well tolerated
#5
hyperbaric oxygen therapy
decrease
tumor response
patients with glioma
-
demonstrate tumor response
#6
hyperbaric oxygen therapy
increase
progression-free survival
patients with glioma
-
increased progression-free survival
#7
hyperbaric oxygen therapy
increase
overall survival
patients with glioma
-
increased overall survival
#8
cannabinoids
no change
safety and tolerability
patients with glioma
-
appear to be safe and well tolerated
#9
cannabinoids
decrease
tumor response
patients with glioma
-
demonstrate tumor response
#10
cannabinoids
increase
progression-free survival
patients with glioma
-
increased progression-free survival
#11
cannabinoids
increase
overall survival
patients with glioma
-
increased overall survival
#12
antioxidants
neutral
survival
patients with glioma
-
exhibit mixed results
#13
antioxidants
increase
survival
patients with low-grade glioma
-
greater effect
#14
vitamin D intake
increase
survival
patients with glioma
-
was associated with prolonged survival
#15
carbogen breathing
no change
survival
patients with glioma
-
were found to have no effect
#16
hypocupremia
no change
survival
patients with glioma
-
were found to have no effect
#17
carbogen breathing
increase
toxicity
patients with glioma
-
associated significant toxicity
#18
hypocupremia
increase
toxicity
patients with glioma
-
associated significant toxicity
#19
Abstract

INTRODUCTION: Complementary and alternative medicine (CAM) are highly used among those diagnosed with glioma. Further research is warranted, however, as it remains important to clearly delineate CAM practices that are unproven, disproven, or promising for future research and implementation. METHODS: A systematic review was conducted to identify all articles that investigated the effect of any CAM therapy on survival of patients with newly diagnosed or recurrent glioma. RESULTS: Eighteen papers and 4 abstracts pertaining to the effects of ketogenic diet (4), antioxidants (3), hyperbaric oxygen (4), cannabinoids (2), carbogen and nicotinamide (3), mistletoe extract (2), hypocupremia and penicillamine (1), and overall CAM use (3) on overall and progression-free survival in patients with low- and high-grade glioma were identified (Levels of Evidence I-IV). Ketogenic diets, hyperbaric oxygen therapy, and cannabinoids appear to be safe and well tolerated by patients; preliminary studies demonstrate tumor response and increased progression-free survival and overall survival when combined with standard of care therapies. Antioxidant usage exhibit mixed results perhaps associated with glioma grade with greater effect on low-grade gliomas; vitamin D intake was associated with prolonged survival. Conversely, carbogen breathing and hypocupremia were found to have no effect on the survival of patients with glioma, with associated significant toxicity. Most modalities under the CAM umbrella have not been appropriately studied and require further investigation. CONCLUSIONS: Despite widespread use, Level I or II evidence for CAM for the treatment of glioma is lacking, representing future research directions to optimally counsel and treat glioma patients.

Medical Subject Headings (MeSH)
Brain NeoplasmsComplementary TherapiesGliomaHumansTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy50/10
Quality65/10
Citation Metrics
Total Citations2
Citations/Year0.5
Relative Citation Ratio0.18
NIH Percentile9.2%
Research Impact Scores
APT Score0.05
Weight Score1.96
Normalized Score0.53
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