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Related Experiment Videos

Placebo effects in oncology.

Gisèle Chvetzoff1, Ian F Tannock

  • 1Department of Medical Oncology, Centre Léon Bérard, Lyon, France.

Journal of the National Cancer Institute
|January 2, 2003
PubMed
Summary

Placebos may offer slight symptom relief for cancer patients, but they do not improve tumor response or quality of life. This study analyzed randomized controlled trials to assess placebo effects in cancer care.

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Area of Science:

  • Oncology
  • Clinical Trials
  • Evidence-Based Medicine

Background:

  • Previous research suggested placebo effects in various disorders, but methodological limitations like lack of blinding and unvalidated endpoints were noted.
  • The efficacy of placebos in cancer patient symptom control and tumor response remains an area requiring rigorous investigation.

Purpose of the Study:

  • To determine the probability of symptom improvement, quality of life enhancement, and tumor response in cancer patients receiving placebos within randomized controlled trials.
  • To test the hypothesis that placebos improve symptom control and quality of life without inducing tumor response.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) involving a placebo arm (37 trials) or best supportive care (BSC) arm (10 trials).
  • Analysis of reported outcomes including pain, appetite, weight gain, quality of life, performance status, and tumor response (assessed by WHO criteria and serum markers).

Main Results:

  • Placebo administration showed limited improvement in average pain (2/6 trials) and appetite (1/7 trials).
  • Individual patient data indicated 0%-21% experienced pain reduction, 8%-27% appetite improvement, 7%-17% weight gain, and 6%-14% improved performance status.
  • Tumor response was rare (2.7% by WHO criteria, 1.7% by serum marker), and quality of life improvements were not consistently reported for individual patients.

Conclusions:

  • In rigorous placebo-controlled trials, placebos can be associated with modest improvements in specific symptoms like pain and appetite.
  • Positive tumor response is rarely observed with placebo treatment in cancer patients.
  • Substantial improvements in overall symptoms and quality of life are unlikely to be solely attributable to placebo effects in cancer care.

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