CELLMED (셀메드)

Cellmed Orthocellular Medicine and Pharmaceutical Association (셀메드 세포교정의약학회)
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Paulinia cupana (Guaraná) for the treatment of cancer related fatigue in patients undergoing radiation therapy or chemotherapy: a meta-analysis of three clinical trials

  • Giglio, Auro Del (Oncology Department ABC Foundation School of Medicine) ;
  • Serpa, Ary (Oncology Department ABC Foundation School of Medicine) ;
  • Cubero, Daniel (Oncology Department ABC Foundation School of Medicine) ;
  • Riechelman, Rachel (Oncology Department ABC Foundation School of Medicine) ;
  • Paschoin, Maira (Oncology Department ABC Foundation School of Medicine)
  • Received : 2011.06.03
  • Accepted : 2011.11.30
  • Published : 2011.11.30
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Abstract

For cancer patients undergoing radiation therapy (RT) or systemic chemotherapy (CHT), cancer-related fatigue (CRF) is a common problem that can negatively impact their quality of life. Guarana (Paullinia cupana) is a plant native to the Amazon basin that has been used as a stimulant since pre-Columbian times. PURPOSE: To evaluate the effectiveness of guarana extract on fatigue in BC patients undergoing either CHT or RT. A total of 137 cancer patients (85% with Breast Cancer) undergoing either CHT (101) or RT (36) were randomized to receive either a placebo or guarana. In all 3 studies, the guarana was given as an unmanipulated dry extract at a dose of 75 mg PO QD in the first two studies or 50 mg PO BID in the third study. Patients were crossed over to the other experimental arm, and we evaluated fatigue with the Chalder Scale in all three studies. Guarana significantly improved the The Chalder Scale Global Scores (- 0.85; 95% CI:-1.31 to -0.40; p = 0.0002); Physical Fatigue Scores (-0.44; 95% CI: - 0.74 to - 0.13; p = 0.005) and Mental Fatigue Scores (-0.93; 95% CI: - 1.14 to - 0.72; p < 0.00001). Guarana did not produce any CTCAE grades 3 or 4 toxicities in any of the studies. Guarana is an effective, cheap and non-toxic alternative for the treatment of fatigue in cancer patients undergoing treatment.

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References

  1. Bruera E, Valero V, Driver L, Shen L, Willey J, Zhang T, Palmer JL. Patient-controlled methylphenidate for cancer fatigue: a double-blind, randomized, placebo-controlled trial. J Clin Oncol. 2006;24(13):2073-2078. https://doi.org/10.1200/JCO.2005.02.8506
  2. Bohlius J, Schmidlin K, Brillant C, Schwarzer G, Trelle S, Seidenfeld J, Zwahlen M, Clarke M, Weingart O, Kluge S, Piper M, Rades D, Steensma DP, Djulbegovic B, Fey MF, Ray- Coquard I, Machtay M, Moebus V, Thomas G, Untch M, Schumacher M, Egger M, Engert A. Recombinant human erythropoiesis-stimulating agents and mortality in patients with cancer: a meta-analysis of randomised trials. Lancet. 2009;373(9674):1532-1542. https://doi.org/10.1016/S0140-6736(09)60502-X
  3. Cheville AL. Cancer-related fatigue. Phys Med Rehabil Clin N Am. 2009;20(2):405-416. https://doi.org/10.1016/j.pmr.2008.12.005
  4. Cho HJ, Costa E, Menezes PR, Chalder T, Bhugra D, Wessely S. Cross-cultural validation of the Chalder Fatigue Questionnaire in Brazilian primary care. J Psychosom Res. 2007;62(3):301-304. https://doi.org/10.1016/j.jpsychores.2006.10.018
  5. da Costa Miranda V, Trufelli DC, Santos J, Campos MP, Nobuo M, da Costa Miranda M, Schlinder F, Riechelmann R, del Giglio A. Effectiveness of guarana (Paullinia cupana) for postradiation fatigue and depression: results of a pilot doubleblind randomized study. J Altern Complement Med. 2009;15(4):431-433. https://doi.org/10.1089/acm.2008.0324
  6. da Costa Miranda V, Trufelli DC, Fede ABS, Martins FD, Saad LS, Oliveira V, Trindade TZC, Riechelman R, del Giglio A. Guarana (Paullinia cupana) for chemotherapy-related fatigue. Einstein (Sao Paulo). 2008;6(2):195-199.
  7. de Oliveira Campos MP, Riechelmann R, Martins LC, Hassan BJ, Casa FB, Del Giglio A. Guarana (Paullinia cupana) improves fatigue in breast cancer patientsundergoing systemic chemotherapy. J Altern Complement Med. 2011;17(6):505-512. https://doi.org/10.1089/acm.2010.0571
  8. Haskell CF, Kennedy DO, Wesnes KA, Milne AL, Scholey AB. A double-blind, placebo-controlled, multi-dose evaluation of the acute behavioural effects of guarana in humans. J Psychopharmacol. 2007;21(1):65-70. https://doi.org/10.1177/0269881106063815
  9. Madden J, Newton S. Why am I so tired all the time? Understanding cancer-related fatigue. Clin J Oncol Nurs. 2006;10(5):659-661. https://doi.org/10.1188/06.CJON.659-661
  10. Minton O, Richardson A, Sharpe M, Hotopf M, Stone P. A systematic review and meta-analysis of the pharmacological treatment of cancer-related fatigue. J Natl Cancer Inst. 2008;100(16):1155-1166. https://doi.org/10.1093/jnci/djn250
  11. Morriss RK, Wearden AJ, Mullis R. Exploring the validity of the Chalder Fatigue scale in chronic fatigue syndrome. J Psychosom Res. 1998;45(5):411-417. https://doi.org/10.1016/S0022-3999(98)00022-1
  12. Smith N, Atroch AL. Guarana's Journey from Regional Tonic to Aphrodisiac and Global Energy Drink. Evid Based Complement Alternat Med. 2007.
  13. Taylor L. The Healing Power of Rainforest Herbs: A Guide to Understanding and Using Herbal Medicinals. Square One Publishers, Inc. First ed. 2005.
  14. Wang XS. Pathophysiology of cancer-related fatigue. Clin J Oncol Nurs. 2008;12(5 Suppl):11-20.