Download Retrospective Study showed positive Results in

Retrospective Study
showed positive Results in Survival
Rate of Patients with Breast Cancer
during Mistletoe Therapy
Therapy with standardised whole mistletoe
extracts (e. g. HELIXOR) is the most
established complementary method of
treatment in adjuvant cancer therapy and
becomes more and more accepted in clinical
oncology. The fact that mistletoe therapy
increases quality of life of cancer patients if it
is applied persistently is largely scientifically
recognized (1). However, the improvement of
survival rates or prolongation of relapse-free
intervals could not be definitely shown by
scientifically accepted methods.
A
retrospective
monocentric
analysis
performed in 3,022 breast cancer patients of
the Tumour Ambulance of the Herdecke
Hospital (2) showed a 10-year survival of
73.3 % for the patients who were treated with
mistletoe extract and whose data could be
evaluated (88 % for stage I, 71.6 % for stage
II, and 55.6 % for stage III).The higher life
expectancy compared to the Munich Cancer
Registry (MCR 2001: 10-year survival rate
55 % in total; stage I 90 %, stage II 65 %,
stage III < 30 %) can be subsumed as a
reference to the efficacy of complementary
oncological measures such as mistletoe
therapy.
Study Design
In cooperation with the Tumour Ambulance of
the Herdecke Hospital and the Department of
Medicinal Biometrics of the Heidelberg
University, a retrospective analysis was
performed in 3,022 breast cancer patients
who were treated in the Herdecke Hospital.
Main objective of the study was the
determination of the survival rate of breast
cancer patients during mistletoe therapy.
Further objectives were tolerance of mistletoe
therapy as well as the analysis of local
recurrences and distant metastases.
The investigation was carried out by means of
a questionnaire which had been sent to the
breast cancer patients by mail, on the
condition that a histological diagnosis had
been established and that each patient had at
least once consulted the Tumour Ambulance
for treatment or medical advice since the
Herdecke Hospital had been founded (1981).
The patients were questioned retrospectively
about possible side effects of mistletoe
therapy. Further questions concerned
adjuvant therapies after surgery such as
chemotherapy, hormonal therapy and
radiotherapy as well as the occurance of local
recurrences
and
distant
metastases.
Additional diagnostic information was
acquired from the hospital’s patient files (type
of
surgery,
TNM
classification,
histopathological grading, status of steroid
hormone receptors, lymph node status,
familial disposition).
Result and Summary
A complete data record regarding gender,
treatment and tumour stage according to UICC
guidelines could be compiled in 1,246 of
3,022 patients included in the study. The
average age of the patients at time of
diagnosis was 49 years. 60 % of the patients
were in tumour stage II, 23 % in stage I and
14 % in stage III; the figures for stages 0 and
IV were very low so that both subgroups could
not be evaluated in a statistically useful way.
Lymph node metastases were diagnosed in
approx. 50 % of all patients but distant
metastases were found in only 3 % of the
patients. In more than 60 % of the patients a
total mastectomy and in one third a breastconserving surgery was performed. Mistletoe
therapy was applied during a period of
approx. 31 months.
48 % of the patients felt better during
mistletoe therapy and only 5 % felt worse as
they did before mistletoe therapy. Almost 80
% of the patients showed slight local
reactions at the subcutaneous injection site
of mistletoe, fact which can be evaluated as a
positive response to the therapy.
Survival time of 867 patients could be
registered. The 10-year survival rate was 73.3
%. Stratification according to tumour stage
showed a 10-year survival rate of 88.1 % for
stage I, 71.6 % for stage II, 55.6 % for stage
III.
Differentiation according to the lymph node
status showed a 10-year survival rate of
63.8 % for lymph node-positive patients and
83.7 % for lymph node-negative patients.
A comparison of these data with the survival
data of breast cancer patients of the Munich
Cancer Registry 2001 (10-year survival rate
approx. 55 %) showed a clear advantage of
the patients treated with mistletoe extract in
Herdecke. The survival benefit was
particularly evident in tumour stage III (see
figure 1).
Patients the data of whom were not available
or incomplete regarding tumour staging or
treatment were classified as drop-outs (1728
patients). Survival time could be evaluated for
465 patients. The 5-year survival rate was
73.1 % and the 10-year survival rate 47.6 %.
Literature
(1) Schierholz, J.M., Schlodder, D.: Komplementäre Tumortherapie mit Mistelextrakten – eine
aktuelle Übersicht [Complementary Tumour
Therapy with Mistletoe Extracts – an Up-toDate Survey], Deutsche Zeitschrift für Onkologie 2003; 35: 124-133
(2) Stumpf, C. et al.: Retrospektive Untersuchung
zur Therapie mit Mistelextrakten bei Mammakarzinom [Retrospective study of breast cancer patients treated with mistletoe extract],
Deutsche Zeitschrift für Onkologie 2005; 37:
106-113
(3) Beuth, J. (Hrsg.): Grundlagen der Komplementäronkologie – Theorie und Praxis [Basics of
Complementary Oncology – Theory and Practice]. Hippokrates Verlag in MVS Medizinverlage
Stuttgart GmbH & Co. KG 2002
Source:
http://www.biometrie.uniheidelberg.de/publikationen/ 46_Mamma_final.pdf
Jörg Michael Schierholz,
Chemist, Physician, M.D., Ph.D., Associate Prof.
1.0
0.8
UICC I
0.6
UICC II
UICC III
0.4
Efficacy of whole mistletoe extracts (e. g.
HELIXOR A, M, P) has been proven since
several decades of medical experience,
summarised in the Viscum album monograph
of the Commission C [in the former Federal
Health Administration]. The improvement of
quality of life of cancer patients, the increase
of the host defence capacity
and the
associated inhibition of tumour growth
without impairment of healthy tissue is the
scientific background for evidence-based
mistletoe therapy.
These promising results still will be confirmed
by evidence-based instruments such as
retrolective cohort studies (EBM level 2).
Survival time of mistletoe patients of the
Tumour Ambulance of Herdecke Hospital
compared to the Munich Cancer Registry 2001
Misteltoe Study
Munich Cancer Registry
0.2
Despite all methodical questions concerning
selection bias, this retrospective analysis
shows a considerable higher survival rate of
the patients treated with mistletoe extracts
compared to the average figures of the
Munich Cancer Registry. The data regarding
survival – with or without complete
documentation in all investigated groups –
show very clearly that the results cannot be
due only to the centre effect. This is in
confirmation with the experimental and
clinical data of mistletoe extracts (3).
Figure 1:
Survival rate
Patients being treated in the Herdecke
Hospital usually received mistletoe therapy. A
small internal control group (n = 18) of
patients without mistletoe therapy showed a
survival of 81.6 % (5 years) and 53.2 % (10
years), data comparable to the Munich Cancer
Registry 2001.
0
2
4
6
Survival Time [years]
UICC I: n = 219
UICC II: n = 531
UICC III: n = 103
8
10
12