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Expert-guided approaches to complementary interventions for common side effects of cancer therapies: a practice-based
Marcela Winkler1, Thomas Breitkreuz2, Jürgen Brust3
1Department of Integrative Medicin, Robert Bosch Hospital, Stuttgart, Germany.
Introduction:
Cancer patients commonly suffer from substantial side effects of oncological therapies. Therefore, the Oncology Working Group of the Competence Network for Integrative Medicine in Baden-Württemberg, Germany (KIM-BW) developed practice-oriented recommendations for the integrative treatment of chemotherapy-induced mucositis (CIM), nausea and vomiting (CINV), and cancer-related fatigue (CRF).
Methods:
Two expert groups of physicians and nurses developed therapeutic recommendations using an interdisciplinary expert consensus process oriented on a Delphi-methodology with a standardized scoring matrix, considering training, feasibility, time intensity, clinical effectiveness, contraindications, and interactions. The consensus process was complemented by a targeted, non-systematic literature search conducted across the AWMF S3 Guideline on Complementary Medicine in Oncology, the KOKON knowledge database, the Working Group on Integrative Care in Oncology, and PubMed/Medline.
Results:
The expert panel consisted of 21 professionals (14 physicians, 7 nurses), all conventionally trained with additional qualifications in integrative disciplines. We evaluated 83 interventions. Top recommendations were identified for each symptom. For CIM: sage tea mouth rinses, ice cubes, sea buckthorn oil mouth rinses, frozen pineapple cubes, and herbal oral balm. For CRF: movement therapy, yarrow liver compresses, viscum album therapy, sleep hygiene with regular circadian rhythms, and hydrotherapy. For CINV: acupressure, ginger, aromatherapy, bitter botanicals such as gentian root, and homeopathic preparation nux vomica.
Conclusions:
Integrative treatment recommendations developed by the KIM Oncology Working Group provide pragmatic, clinically grounded guidance for integrative management of common treatment-related symptoms in oncology. Prospective evaluation of safety, effectiveness, and implementation across settings is warranted.
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