Research: TRÖGER and COLLEAGUES,

Listed in Issue 249

Abstract

TRÖGER and COLLEAGUES, 1 Clinical Research Dr. Tröger, Freiburg; 2 First Surgical Clinic of the Clinical Centers of Servia (Belgrade); 3 Institute for Clinical Research, Berlin. 4 CLINICOBSS, Niš, Serbia; 5 Faculty of Medicine, University of Belgrade, Serbia studied whether the quality of life of patients with advanced pancreatic cancer could be improved by mistletoe extract.

Background

The treatment of cancer patients with mistletoe extract is said to prolong their survival and, above all, improve their quality of life. We studied whether the quality of life of patients with advanced pancreatic cancer could be improved by mistletoe extract.

Methodology

An open, single-center, group-sequential, randomized phase III trial (ISRCTN70760582) was conducted. From January 2009 to December 2010, 220 patients with locally advanced or metastatic pancreatic cancer who were receiving no further treatment for pancreatic cancer other than best supportive care were included in this trial. They were stratified by prognosis and randomly allocated either to a group that received mistletoe treatment or to one that did not. Mistletoe extract was given in escalating doses by subcutaneous injection three times a week. The planned interim evaluation of data from 220 patients indicated that mistletoe treatment was associated with longer overall survival, and the trial was terminated prematurely. After termination of the study, the results with respect to quality of life (assessed with the QLO-C30 scales of the European Organisation for Research and Treatment of Cancer) and trends in body weight were evaluated.

Results

Data on quality of life and body weight were obtained from 96 patients treated with mistletoe and 72 control patients. Those treated with mistletoe did better on all 6 functional scales and on 7 of 9 symptom scales, including pain (95% confidence interval [CI] -29 to -17), fatigue (95% CI -36.1 to -25.0), appetite loss (95% CI -51 to -36.7), and insomnia (95% CI -45.8 to -28.6). This is reflected by the trend in body weight during the trial.

Conclusion

In patients with locally advanced or metastatic pancreatic carcinoma, mistletoe treatment significantly improves the quality of life in comparison to best supportive care alone. Mistletoe is an effective second-line treatment for this disease.

References

Tröger W1, Galun D2, Reif M3, Schumann A3, Stanković N4, Milićević M5. Quality of life of patients with advanced pancreatic cancer during treatment with mistletoe: a randomized controlled trial. Dtsch Arztebl Int. 111(29-30):493-502, 33 p following 502. doi: 10.3238/arztebl.2014.0493. www.ncbi.nlm.nih.gov/pubmed/25142075. Jul 21 2014.

Comment

The above randomized phase III trial demonstrated that mistletoe treatment significantly improves the quality of life in comparison to best supportive care alone in patients with advanced pancreatic cancer.

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