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11 oktober 2021: Bron: Loef and Walach BMC Complementary Medicine and Therapies (2020) 20:227
Maretakinjecties gebruikt naast een reguliere behandeling tegen kanker verbetert meestal de kwaliteit van leven. Dat blijkt uit een reviewstudie van 26 gerandomiseerde studies bij kankerpatiënten met verschillende vormen van kanker.
Uit de meta-analyse van de studies tesamen blijkt het verschil in kwaliteit van leven 50 procent of meer in vergelijking met controlegroepen. (d = 0.61 (95% CI 0.41–0.81, p < 0,00001).
Het effect was sterker bij jongere patiënten, met een langere behandeling, ook was het effect sterker in onderzoeken met een lager risico op bias, zoals in gerandomiseerde en geblindeerde studies. Gevoeligheidsanalyses ondersteunen de validiteit van de bevinding. 50% van de patiënten ervaarden bijv. minder pijn en misselijkheid.
Wel schrijven de auteurs in hun conclusie: Maretakextracten hebben een statistisch significant, middelgroot effect op de kwaliteit van leven bij kanker. Risico op vooringenomenheid (bias) in de geanalyseerde onderzoeken is waarschijnlijk te wijten aan het specifieke type behandeling, dat moeilijk blind te onderzoeken is; maar ondanks dit risico is het onwaarschijnlijk dat het de uitkomst heeft beïnvloed. De geanalyseerde studies vertonen een significante verbetering van de kwaliteit van leven na behandeling met maretakinjecties.
Het volledige studieverslag van deze reviewstudie is te lezen en tge downloaden in een PDF. Klik op de titel van het abstract voor het volledige studieverslag.
Quality of life in cancer patients treated with mistletoe: a systematic review and meta-analysis Martin Loef1 and Harald Walach1,2,3*
Abstract
Background: Mistletoe extracts are used as an adjunct therapy for cancer patients, but there is dissent as to whether this therapy has a positive impact on quality of life (QoL).
Methods: We conducted a systematic review searching in several databases (Medline, Embase, CENTRAL, CINAHL, PsycInfo, Science Citation Index, clinicaltrials.gov, opengrey.org) by combining terms that cover the fields of “neoplasm”, “quality of life” and “mistletoe”. We included prospective controlled trials that compared mistletoe extracts with a control in cancer patients and reported QoL or related dimensions. The quality of the studies was assessed with the Cochrane Risk of Bias tool version 2. We conducted a quantitative meta-analysis.
Results: We included 26 publications with 30 data sets. The studies were heterogeneous. The pooled standardized mean difference (random effects model) for global QoL after treatment with mistletoe extracts vs. control was d = 0.61 (95% CI 0.41–0.81, p < 0,00001). The effect was stronger for younger patients, with longer treatment, in studies with lower risk of bias, in randomized and blinded studies. Sensitivity analyses support the validity of the finding. 50% of the QoL subdomains (e.g. pain, nausea) show a significant improvement after mistletoe treatment. Most studies have a high risk of bias or at least raise some concern.
Conclusion: Mistletoe extracts produce a significant, medium-sized effect on QoL in cancer. Risk of bias in the analyzed studies is likely due to the specific type of treatment, which is difficult to blind; yet this risk is unlikely to affect the outcome. PROSPERO registration: CRD42019137704.
Availability of data and materials
The database on which this study is based is available on request from the authors.
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Acknowledgments
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Funding
This study was funded by the Förderverein komplementärmedizinische Forschung, Arlesheim, Switzerland. The funding body had no influence in the design of the study, the collection, analysis, and interpretation of data and in writing the manuscript.
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Both authors contributed equally. HW developed the protocol, ML edited and improved it and submitted it to PROSPERO. ML developed and implemented the search strategy. Both authors extracted the data independently, discussed discrepancies, and calculated the analyses independently. ML calculated the quantitative analysis reported and HW calculated the sensitivity analyses reported. ML wrote the first draft of the paper and HW edited and contributed to writing. Both authors analyzed and interpreted the data. All authors have read and approved the manuscript.
Author’s information
Harald Walach is a professor with Poznan Medical University, where he teaches mindfulness to the international medical students, and he is a visiting professor with University Witten-Herdecke, where he teaches philosophical foundations of psychology to psychology undergraduates. Apart from that he is founder and director of the Change Health Science Institute (www.chs-institute.org), based in Berlin Germany. Martin Loef is an independent researcher and Harald Walach’s partner in the CHS Institute, Berlin. He is a specialist in conducting systematic reviews and meta-analyses and lifestyle diagnostics.
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Loef, M., Walach, H. Quality of life in cancer patients treated with mistletoe: a systematic review and meta-analysis. BMC Complement Med Ther 20, 227 (2020). https://doi.org/10.1186/s12906-020-03013-3
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