Example Queries
What are the indications for taking selenium?
| Outcome name | Results during intervention | Overall RoB judgment | |
|---|---|---|---|
| Asfour et al. (2006): Effect of high-dose sodium selenite therapy on polymorphonuclear leukocyte apoptosis in non-Hodgkin's lymphoma patients | Ejection fraction | After chemotherapy (8 days): significantly better cardiac ejection fraction in sodium selenite arm (mean(SD)= 63(6%)) vs. control arm (69(6%)); p <0.05 | high risk |
| Asfour et al. (2006): Effect of high-dose sodium selenite therapy on polymorphonuclear leukocyte apoptosis in non-Hodgkin's lymphoma patients | Toxicity | After chemotherapy (8 days): significant less infections in sodium selenite arm (20%) compared to control arm (67%); p<0.05 | high risk |
| Büntzel et al. (2010): Limited effects of selenium in the prevention of radiation-associated toxicities - results of a randomized study in head neck cancer patients | Toxicity | Maximum toxicity intervention vs. control arm: dysphagia 22.7% vs. 35.3%, ageusia 22.7% vs. 47.1%, xerostomia 22.7% vs. 23.5%, and stomatitis 36.4% vs. 23.5%; no significant differences; Significant mean difference between arms only for dysphagia at week 7: mean intervention arm 1.533 vs. control 2.167 (p=0.05) | some concerns |
| ... further results | |||
What are the side effects of cannabis?
| Side Effects / Interactions | |
|---|---|
| Côté et al. (2016): Improving Quality of Life With Nabilone During Radiotherapy Treatments for Head and Neck Cancers: A Randomized Double-Blind Placebo-Controlled Trial | No differences for sleepiness (p=0.32), anxiety (p=0.92) and xerostomia (p=0.83) No differences for sleepiness (p=0.32), anxiety (p=0.92) and xerostomia (p=0.83) |
| Fallon et al. (2017) I: Sativex oromucosal spray as adjunctive therapy in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy: two double-blind, randomized, placebo-controlled phase 3 studies | Overall 68% at least one event; assessed as probably intervention-associated with frequency ≥ 5%:
Total n=64 (32.2%), of which somnolence n=18 (9%), dizziness n=15 (7.5%), nausea n=10 (5%)
|
| Fallon et al. (2017) II: Sativex oromucosal spray as adjunctive therapy in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy: two double-blind, randomized, placebo-controlled phase 3 studies | Part A
Overall 60% at least one event, assessed as probably intervention-associated with frequency ≥ 5%: Total n=128, 31.7%, somnolence (n=42, 10.4%), nausea (n=21, 5.2%) and dizziness (n=21, 5.2%) Part B Overall 72% at least one event; assessed as probably intervention-associated with frequency ≥ 5%: Total n=16, 15.5%; somnolence (n=6, 5.8%)
None of the deaths related to intervention Overall 60% at least one event, assessed as probably intervention-associated with frequency ≥ 5%: Total n=128, 31.7%, somnolence (n=42, 10.4%), nausea (n=21, 5.2%) and dizziness (n=21, 5.2%)
|
| Grimison et al. (2020): Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial | Moderate or severe cannabinoid-related side effects in intervention arm and placebo arm (31% vs. 7%, p=0.002):
|
| Jatoi et al. (2002): Dronabinol Versus Megestrol Acetate Versus Combination Therapy for Cancer-Associated Anorexia: A North Central Cancer Treatment Group Study | Impotence in 18 % of men; vomiting; fluid retention; confused thinking; drowsiness; loss of coordination; inappropriate behavior Impotence in 4% of men; vomiting; fluid retention; confused thinking; drowsiness; loss of coordination; inappropriate behavior Impotence in 14% of men; vomiting; fluid retention; confused thinking; drowsiness; loss of coordination; inappropriate behavior |
| ... further results | |
Does curcumin help against nausea?
What is cannabis recommended for/against?
Does selenium help with mucositis?
| Outcome specification | Results during intervention | Results after intervention | Overall RoB judgment | |
|---|---|---|---|---|
| Jahangard-Rafsanjani et al. (2013): The efficacy of selenium in prevention of oral mucositis in patients undergoing hematopoietic SCT: a randomized clinical trial | Neutrophil and platelet engraftment time (the time point after transplantation at which a patient can maintain a sustained ANC of 4500 cells/mm3 and a sustained platelet count of at least 20 000/mm3 lasting 3 consecutive days without transfusions during hospital stay) NA Graft-versus-host disease is a condition where the donated stem cells (graft) attack the recipient's body (host) At 3 months Serum creatinine level and blood urea nitrogen test for renal function assessment and aspartate aminotransferase and alanine transaminase for liver function assessment, recorded daily NA Oral Mucositis Duration of fever | No difference between arms (p=0.32, p=0.87) NA NA NA NA NA Onset of mucositis after transplantation comparable in both selenium and placebo arm; p=0.81 Fever above 38.3°C in 72 patients (97.3%) during neutropenia; duration of fever comparable in both selenium and placebo arm ; p=0.98 | NA No difference between selenium arm (26.92±6.26 days) and placebo arm (25.81±4.33 days); p=0.38 Overall: No difference between the arms; p= 0.35 No difference between the arms; p= 0.69 Overall: No difference between arms for increase in serum creatinine; p=0.31 or increase in aspartate aminotransferase and alanine transaminase: p=0.62 Significant difference in mean serum selenium level between two arms at 14 days after transplantation (8.34 mcg/dL in the selenium arm vs 7.36 mcg/dL in the placebo arm), p=0.018 Overall: Cumulative incidence (grade 1-4) comparable in both selenium arm (83.8%) and placebo arm (81.1%); p=0.76; grade 3-4 mucositis significantly lower in selenium arm (10.8%) compared to placebo arm (35.1%); p=0.013 (grade 4: 2x in placebo arm, 0x in selenium arm)
NA | some concerns some concerns some concerns some concerns some concerns some concerns high risk some concerns |
| Laali et al. (2020): Effect of Selenium on Incidence and Severity of Mucositis during Radiotherapy in Patients with Head and Neck Cancer | NA Inflammation of the oral mucosa (mucositis) due to radiotherapy | NA Significant difference for incidence of severe mucositis at week 3: selenium arm 9.8% vs. placebo arm 42.0% (p=0.017) | At the end of radiation (after 7 weeks) there was no difference in the mean serum selenium level between the selenium arm and placebo arm (p=0.24)
Based on the selenium level before radiation, developing severe oral mucositis was statistically significant postponed in patients who had selenium levels ≥ 65 mcg/L (p=0.04)
| NA high risk |
| Mix et al. (2015): Randomized phase II trial of selenomethionine as a modulator of efficacy and toxicity of chemoradiation in squamous cell carcinoma of the head and neck | Grade 3 or 4 Complete response rate (CR) NA NA Measured with EORTC C-30 Version 3 and EORTC QLQ - H&N35 Other treatment-associated side effects such as xerostomia, renal impairment, hearing dysfunction, and myelosuppression | NA NA NA NA No significant difference for the 7 weeks of intervention NA | Overall: No significant differences between arms (grade 3 intervention arm 2x, placebo arm 3x, no grade 4) Only one patient from the intervention arm did not reach CR and died After 12 months: No significant differences between arms After 12 months: No significant differences between arms No significant difference for week 6-8 post-treatment and Follow-up within a year Overall:
| some concerns low risk low risk low risk some concerns some concerns |
What is the optimal dosage of cannabis for the treatment of nausea?
| Outcome name | Outcome specification | Dosage and regime | |
|---|---|---|---|
| Côté et al. (2016): Improving Quality of Life With Nabilone During Radiotherapy Treatments for Head and Neck Cancers: A Randomized Double-Blind Placebo-Controlled Trial | Pain Weight Appetite Nausea Unspecified effects Toxicity Quality of life | Pain with VAS + number of other analgesics used Weight fluctuations, total days without feeding tube or gastrostomy Appetite with questionnaire (no further information) Nausea with questionnaire (no further information) + number of antiemetic drugs used Sleep quality and mood (no information on survey) Toxicity of nabilone Quality of life (target improvement of 15 points at week 7) | 0.5 mg nabilone tablets (from Valeant Canada)
|
| Grimison et al. (2020): Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial | CINV (Chemotherapy-Induced Nausea and Vomiting) CINV (Chemotherapy-Induced Nausea and Vomiting) Quality of life Toxicity | Complete response, no vomiting or emergency medication 0-120h of chemotherapy Self-reported "complete response" ("no vomiting", "no clinically significant nausea", defined as nausea <2 on a 10-point scale, and "no use of emergency medication") during the acute (0-24 h), delayed (24-120 h) and general phase (0-120 h) of chemotherapy with diary day -1 to 6 of each cycle) Quality of life (nausea & vomiting scales) at baseline, day -1, end of treatment Self-developed measurement instrument: structured checklist of cannabinoid-specific adverse events | 1-4 capsules (each THC 2.5mg/CBD 2.5mg) 3x daily from one day before chemotherapy to day 5; median (SD) number of capsules: 2 (1-3) Median (SD) number of capsules = 3 (2-4) |
| Johnson et al. (2010): Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain | Pain Pain Sleep Nausea Cognitive functioning Cognitive functioning Appetite Quality of life Pain | Number of responders (≥ 30% pain reduction NRS scale baseline vs. 14-20 days) Breakthrough pain and corresponding opioid intake and daily opioid use with diary Numeric Rating Scale (NRS) over the last 24h Sleep quality Nausea Memory Concentration Appetite Quality of life at baseline and 14-21 days after Pain at baseline and 14-21 days after | THC:CBD via oral spray (self-applied by patient, one dose 2.7mg THC and 2.5mg CBD)
Week 1: dose finding Week 2: stable dose, maximum of 8 sprays every 3 hours and 48 sprays in 24 hours: dose was determined by patients themselves NI |
| Strasser et al. (2006): Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled (…) | Appetite Quality of life Mood/Affect Nausea Anorexia/Cachexia Toxicity Functionality Weight | Change from baseline to week 6 Change from baseline to week 6, measured with a composite score (mean) of questions 29 (Global Health Status) and 30 (QOL) of the EORTC QLQ-C30, twice a week Mood, measured daily Measured daily Measured with the anorexia-cachexia module of the EORTC QLQ-C30 Cannabinoid-related toxicity with CannTox module (based on the Drug Reaction Scale of adjectives describing mood, physical feelings, and perceptions of mental or cognitive functions of healthy volunteers under the influence of cannabis); measured twice a week Measured with functional scales and individual items of the EORTC QLQ-C30 (physical, role, emotional, cognitive, and social functioning; and dyspnea, diarrhea, and financial problems) NI | 2.5mg THC orally, 2x a day, preferably taken before lunch and dinner/at bedtime 2,5mg THC + 1mg cannabidiol, 2x a day, preferably taken before lunch and dinner/at bedtime 2x a day, preferably taken before lunch and dinner/at bedtime |