This complementary and alternative medicine (CAM) information summary provides an overview of the use of aromatherapy and essential oils primarily to improve the quality of life of cancer patients. This summary includes a brief history of aromatherapy, a review of laboratory studies and clinical trials, and possible adverse effects associated with aromatherapy use.
This summary contains the following key information:
Aromatherapy is the therapeutic use of essential oils (also known as volatile...
The goal of the first phase of therapy (remission induction) is to induce a complete remission (CR). This phase typically lasts 4 weeks. Overall, approximately 98% of patients with newly diagnosed B-precursor ALL achieve CR by the end of this phase, with somewhat lower rates in patients with T-cell ALL or high presenting leukocyte counts.[1,2,3,4,5]
Induction chemotherapy consists of the following drugs, with or without an anthracycline:
Corticosteroid (prednisone or dexamethasone).
The Children's Oncology Group (COG) protocols do not administer anthracycline during induction to patients with National Cancer Institute standard-risk precursor B-cell ALL.
Patients treated by the following study groups receive an induction regimen with four or more drugs regardless of presenting features:
The most common four-drug induction regimen is vincristine, corticosteroid (either dexamethasone or prednisone), L-asparaginase, and either doxorubicin or daunorubicin. Some studies have suggested that this more intensive induction regimen may result in improved event-free survival (EFS) in patients presenting with high-risk features, but it may not be necessary for favorable outcome provided that adequate postremission intensification therapy is administered.[7,8] The COG reserves the use of a four-drug induction for patients with high-risk B-precursor ALL and T-cell ALL.
Many current regimens utilize dexamethasone instead of prednisone during remission induction and later phases of therapy.
The Children's Cancer Group conducted a randomized trial that compared dexamethasone and prednisone in standard-risk ALL patients.
The trial reported that dexamethasone was associated with a superior EFS.
Another randomized trial was conducted by the United Kingdom Medical Research Council.
The trial demonstrated that dexamethasone was associated with a more favorable outcome than prednisolone in all patient subgroups.
Patients who received dexamethasone had a significantly lower incidence of both central nervous system (CNS) and non-CNS relapses than patients who received prednisolone.
Other randomized trials did not confirm an EFS advantage with dexamethasone.[11,12]