Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: Systematic review and meta-analysis

Department of Psychiatry, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil, &
European Journal of Cancer Care (Impact Factor: 1.56). 08/2008; 17(5):431 - 443. DOI: 10.1111/j.1365-2354.2008.00917.x
Source: PubMed


This paper aims to evaluate the anti-emetic efficacy of cannabinoids in cancer patients receiving chemotherapy using a systematic review of literature searched within electronic databases such as PUBMED, EMBASE, PSYCINFO, LILACS, and ‘The Cochrane Collaboration Controlled Trials Register’. Studies chosen were randomized clinical trials comprising all publications of each database until December 2006. From 12 749 initially identified papers, 30 fulfilled the inclusion criteria for this review, with demonstration of superiority of the anti-emetic efficacy of cannabinoids compared with conventional drugs and placebo. The adverse effects were more intense and occurred more often among patients who used cannabinoids. Five meta-analyses were carried out: (1) dronabinol versus placebo [n = 185; relative risk (RR) = 0.47; confidence interval (CI) = 0.19–1.16]; (2) Dronabinol versus neuroleptics [n = 325; RR = 0.67; CI = 0.47–0.96; number needed to treat (NNT) = 3.4]; (3) nabilone versus neuroleptics (n = 277; RR = 0.88; CI = 0.72–1.08); (4) levonantradol versus neuroleptics (n = 194; RR = 0.94; CI = 0.75–1.18); and (5) patients' preference for cannabis or other drugs (n = 1138; RR = 0.33; CI = 0.24–0.44; NNT = 1.8). The superiority of the anti-emetic efficacy of cannabinoids was demonstrated through meta-analysis.

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    • "Research with cannabinoids for the prevention of nausea and vomiting in patients receiving chemotherapy was conducted in the 1980s toward the approval of these drugs for this indication, compared to placebo or various neuroleptic drugs. A meta-analysis that combined the different cannabis treatments compared to neuroleptics and included over 1100 patients from 18 studies found a strong significance in favor of the cannabinoids [13]. It should be noted that these drugs were not compared to any of the new antinausea drugs. "
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    ABSTRACT: Background. Cancer patients using cannabis report better influence from the plant extract than from synthetic products. However, almost all the research conducted to date has been performed with synthetic products. We followed patients with a medicinal cannabis license to evaluate the advantages and side effects of using cannabis by cancer patients. Methods. The study included two interviews based on questionnaires regarding symptoms and side effects, the first held on the day the license was issued and the second 6-8 weeks later. Cancer symptoms and cannabis side effects were documented on scales from 0 to 4 following the CTCAE. The distress thermometer was used also. Results. Of the 211 patients who had a first interview, only 131 had the second interview, 25 of whom stopped treatment after less than a week. All cancer or anticancer treatment-related symptoms showed significant improvement (P < 0.001). No significant side effects except for memory lessening in patients with prolonged cannabis use (P = 0.002) were noted. Conclusion. The positive effects of cannabis on various cancer-related symptoms are tempered by reliance on self-reporting for many of the variables. Although studies with a control group are missing, the improvement in symptoms should push the use of cannabis in palliative treatment of oncology patients.
    Full-text · Article · Jul 2013 · Evidence-based Complementary and Alternative Medicine
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    • "Cannabis sativa is being prescribed and used in several medical conditions. It is used in the management of chemotherapy-induced nausea and vomiting among cancer patients (Machado Rocha et al., 2008) and for relief of spasticity in multiple sclerosis patients (Sastre-Garriga et al., 2011). Medical cannabis is also used to alleviate chronic pain and arthritis (Swift et al., 2005) and neuropathic pain caused by diabetes (Selvarajah et al., 2010) and to improve the wellbeing in patients with depression (Denson and Earleywine, 2006). "

    Full-text · Article · Jan 2013
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    • "Cannabis is the most frequently used illegal drug in Europe, most often self-administered for its mood-altering or " relaxing " effects (Green et al., 2003; Vicente et al., 2008). The use of cannabis and other cannabinoids for medical purposes as an analgesic or antiemetic for example is on the rise (Machado Rocha et al., 2008; Elikkottil et al., 2009). Surprisingly, to date the effect of cannabinoids on human performance monitoring is not sufficiently understood. "
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    ABSTRACT: Rationale: The error-related negativity (ERN) is a negative event-related potential that occurs immediately after an erroneous response and is thought to reflect human performance monitoring. Delta-9-Tetrahydrocannabinol (THC) administration in healthy volunteers has been linked to impaired performance monitoring in behavioral studies, but to date no studies have examined the effects of cannabinoids on the ERN. Methods: EEG data from 10 healthy volunteers was recorded during execution of a speeded choice-reaction-time task (Flankers task) after administration of THC or placebo vapor in a double-blind randomized crossover design. Results: The findings of this study show that the ERN was significantly reduced after administration of THC. The behavioral outcomes on the Flankers task showed no indications of drug-induced impairments. Discussion: The diminished ERN reflects impairments in the process of performance monitoring. The task design was not optimized to find behavioral effects. The study shows that cannabinoids impair performance monitoring.
    Full-text · Article · Sep 2011 · Frontiers in Behavioral Neuroscience
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