Zie ook in de literatuurlijsten samengesteld door arts-bioloog drs. Engelbert Valstar en waarvan wij per vorm van kanker of naast operatie, chemo of bestraling of een beenmergtransplantatie weer aparte literatuurlijsten hebben gemaakt. En in een aantal lijsten komen ook daarin de maretakinjecties voor. 

Zie ook in gerelateerde artikelen. 

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.

References

  1. 1.

    Mattiuzzi C, Lippi G. Current cancer epidemiology. J Epidemiol Global Health. 2019;9(4):217–22.

    Google Scholar 

  2. 2.

    Goerling U, Stickel A. Quality of life in oncology. Recent Results Cancer Res. 2014;197:137–52.

    PubMed Google Scholar 

  3. 3.

    Jitender S, Mahajan R, Rathore V, Choudhary R. Quality of life of cancer patients. J Exp Ther Oncol. 2018;12(3):217–21.

    PubMed Google Scholar 

  4. 4.

    Bussing A. Mistletoe: the genus Viscum. Amsterdam: Harwood Academic; 2000.

    Google Scholar 

  5. 5.

    Pfüller U. Chemical Constituents of European Mistletoe (Viscum album L.) Isolation and Characterisation of the Main Relevant Ingredients: Lectins, Viscotoxins, Oligo−/polysaccharides, Flavonoides, Alkaloids. Mistletoe: CRC Press; 2003. p. 117–38.

    Google Scholar 

  6. 6.

    Berg JM, Tymoczko JL, Stryer L. Biochemistry. Jeremy M. Berg, John L. Tymoczko, Lubert Stryer; with Gregory J. Gatto, Jr. New York: WH Freeman; 2012.

  7. 7.

    Hoessli DC, Ahmad I. Mistletoe lectins: carbohydrate-specific apoptosis inducers and immunomodulators. Curr Org Chem. 2008;12(11):918–25.

    CAS Google Scholar 

  8. 8.

    Hajto T, Hostanska K, Gabius H-J. Modulatory potency of the β-galactoside-specific lectin from mistletoe extract (Iscador) on the host defense system in vivo in rabbits and patients. Cancer Res. 1989;49(17):4803–8.

    CAS PubMed Google Scholar 

  9. 9.

    Hülsen H, Born U. Einfluss von Mistelpräparaten auf die in-vitro-Aktivität der natürlichen Killerzellen von Krebspatienten (Teil 2). Therapeutikon. 1993;7(10):434–9.

    Google Scholar 

  10. 10.

    Büssing A, Suzart K, Bergmann J, Pfüller U, Schietzel M, Schweizer K. Induction of apoptosis in human lymphocytes treated with Viscum album L. is mediated by the mistletoe lectins. Cancer Lett. 1996;99(1):59–72.

    PubMed Google Scholar 

  11. 11.

    Greń A, Formicki G, Massanyi P, Szaroma W, Lukáč N, Kapusta E. Use of Iscador, an extract of mistletoe (Viscum album L.) in treatment. Journal of microbiology. Biotechnol Food Sci. 2019;2019:19–20.

    Google Scholar 

  12. 12.

    Huber R, Rostock M, Goedl R, Ludtke R, Urech K, Buck S, et al. Mistletoe treatment induces GM-CSF-and IL-5 production by PBMC and increases blood granulocyte-and eosinophil counts: a placebo controlled randomized study in healthy subjects. Eur J Med Res. 2005;10(10):411.

    CAS PubMed Google Scholar 

  13. 13.

    Oei SL, Thronicke A, Schad F. Mistletoe and immunomodulation: insights and implications for anticancer therapies. Evid Based Complement Alternat Med. 2019;2019:5893017. https://doi.org/10.1155/2019/5893017.

  14. 14.

    Büssing A, Raak C, Ostermann T. Quality of life and related dimensions in cancer patients treated with mistletoe extract (iscador): a meta-analysis. Evid Based Complement Alternat Med. 2012;2012.

  15. 15.

    Ernst E, Schmidt K, Steuer-Vogt MK. Mistletoe for cancer? A systematic review of randomised clinical trials. Int J Cancer. 2003;107(2):262–7.

    CAS PubMed Google Scholar 

  16. 16.

    Freuding M, Keinki C, Kutschan S, Micke O, Buentzel J, Huebner J. Mistletoe in oncological treatment: a systematic review: part 2: quality of life and toxicity of cancer treatment. J Cancer Res Clin Oncol. 2019b.

  17. 17.

    Freuding M, Keinki C, Micke O, Buentzel J, Huebner J. Mistletoe in oncological treatment: a systematic review. J Cancer Res Clin Oncol. 2019a;145(3):695–707.

    CAS PubMed Google Scholar 

  18. 18.

    Horneber M, Bueschel G, Huber R, Linde K, Rostock M. Mistletoe therapy in oncology. Cochrane Database Syst Rev. 2008;(2).

  19. 19.

    Kienle GS, Kiene H. Influence of Viscum album L (European mistletoe) extracts on quality of life in cancer patients: a systematic review of controlled clinical studies. Integr Cancer Ther. 2010;9(2):142–57.

    PubMed Google Scholar 

  20. 20.

    Melzer J, Iten F, Hostanska K, Saller R. Efficacy and safety of mistletoe preparations (Viscum album) for patients with cancer diseases. Complement Med Res. 2009;16(4):217–26.

    Google Scholar 

  21. 21.

    Higgins JPT, Thomas J, Chandler J, Cumpston M LT, Page MJ, Va W, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 6: The Cochrane Collaboration; 2019.

    Google Scholar 

  22. 22.

    Cochrane. RoB 2: A revised Cochrane risk-of-bias tool for randomized trials 2019 [Available from: https://methods.cochrane.org/bias/resources/rob-2-revised-cochrane-risk-bias-tool-randomized-trials.

  23. 23.

    Wells G. The Newcastle-Ottawa Scale (NOS) for assessing the quality of non randomised studies in meta-analyses. 2001. http://www.ohri.ca/programs/clinical_epidemiology/oxfordasp. Accessed 11 Aug 2019.

  24. 24.

    Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.

    PubMed Google Scholar 

  25. 25.

    Sterne JA, Egger M. Regression methods to detect publication and other bias in meta-analysis. Publication bias in meta-analysis: Prevention, assessment and adjustments; 2005. p. 99–110.

    Google Scholar 

  26. 26.

    Bar-Sela G, Wollner M, Hammer L, Agbarya A, Dudnik E, Haim N. Mistletoe as complementary treatment in patients with advanced non-small-cell lung cancer treated with carboplatin-based combinations: a randomised phase II study. Eur J Cancer. 2013;49(5):1058–64.

    CAS PubMed Google Scholar 

  27. 27.

    Borrelli E. Evaluation of the quality of life in breast cancer patients undergoing lectin standardized mistletoe therapy. Minerva Medica. 2001;92(Suppl 1 Nr 3):105–7.

    Google Scholar 

  28. 28.

    Dold U, LE, Mäurer HC, Müller-Wening D, Sakellariou B, Trendelenburg F, Wagner G. Krebszusatztherapie beim fortgeschrittenen nicht-kleinzelligen Bronchialkarzinom. Stuttgart-New York: Georg Thieme Verlag; 1991.

    Google Scholar 

  29. 29.

    Enesel MB, Acalovschi I, Grosu V, Sbarcea A, Rusu C, Dobre A, et al. Perioperative application of the Viscum album extract Isorel in digestive tract cancer patients. Anticancer Res. 2005;25(6C):4583–90.

    PubMed Google Scholar 

  30. 30.

    Grah C. Misteltherapie bei nichtkleinzelligem Bronchialkarzinom. Berlin: Fu-Berlin; 2010.

    Google Scholar 

  31. 31.

    Grossarth-Maticek R, Ziegler R. Prospective controlled cohort studies on long-term therapy of breast cancer patients with a mistletoe preparation (Iscador®). Complement Med Res. 2006a;13(5):285–92.

    Google Scholar 

  32. 32.

    Grossarth-Maticek R, Ziegler R. Randomised and non-randomised prospective controlled cohort studies in matched-pair design for the long-term therapy of breast cancer patients with a mistletoe preparation (Iscador): a re-analysis. Eur J Med Res. 2006b;11(11):485.

    CAS PubMed Google Scholar 

  33. 33.

    Grossarth-Maticek R, Ziegler R. Efficacy and safety of the long-term treatment of melanoma with a mistletoe preparation (Iscador). Schweizerische Zeitschrift für Ganzheitsmedizin. 2007c;19(6):325.

  34. 34.

    Grossarth-Maticek R, Ziegler R. Prospective controlled cohort studies on long-term therapy of ovarian cancer patients with mistletoe (Viscum album L.) extracts Iscador. Arzneimittelforschung. 2007b;57(10):665–78.

    CAS PubMed Google Scholar 

  35. 35.

    Grossarth-Maticek R, Ziegler R. Prospective controlled cohort studies on long-term therapy of cervical cancer patients with a mistletoe preparation (Iscador®). Complement Med Res. 2007a;14(3):140–7.

    Google Scholar 

  36. 36.

    Grossarth-Maticek R, Ziegler R. Randomized and non-randomized prospective controlled cohort studies in matched pair design for the long-term therapy of corpus uteri cancer patients with a mistletoe preparation (Iscador). Eur J Med Res. 2008;13(3):107.

    CAS PubMed Google Scholar 

  37. 37.

    Heiny B. Additive Therapie mit standardisiertem Mistelextrakt reduziert die Leukopenie und verbessert die Lebensqualität von Patientinnen mit fortgeschrittenem Mammakarzinom unter palliativer Chemotherapie (VEC-schema). Krebsmedizin. 1991;12:1–14.

    Google Scholar 

  38. 38.

    Heiny BM, Albrecht V, Beuth J. Stabilization of the quality of life by mistletoe lectin-1 standardized mistletoe extract in advanced colorectal carcinoma. Onkologe. 1998;4(SUPPL. 1):S35–S8.

    Google Scholar 

  39. 39.

    Kaiser G, Büschel M, Horneber M, Smetak M, Birkmann J, Braun W, et al. Studiendesign und erste Ergebnisse einer prospektiven placebokontrollierten, randomisierten Studie mit AbnobaViscum Mali 4. [Prospective, randomised, placebo-controlled, double-blind study with a mistletoe extract: Study design and early results]. In: Scheer R, Bauer R, Becker H, Berg PA, Fintelmann V, editors. Die Mistel in der Tumortherapie: Grundlagenforschung und Klinik [Mistletoe in tumor therapy: Basic research and clinic]. Essen: KVC publisher; 2001. p. 485–505. .

  40. 40.

    Kim KC, Yook JH, Eisenbraun J, Kim BS, Huber R. Quality of life, immunomodulation and safety of adjuvant mistletoe treatment in patients with gastric carcinoma - a randomized, controlled pilot study. BMC Complement Altern Med. 2012;12(172):1472–6882.

    Google Scholar 

  41. 41.

    Lenartz D, Stoffel B, Menzel J, Beuth J. Immunoprotective activity of the galactoside-specific lectin from mistletoe after tumor destructive therapy in glioma patients. Anticancer Res. 1996;16(6B):3799–802.

    CAS PubMed Google Scholar 

  42. 42.

    Loewe-Mesch A, Kuehn J, Borho K, Abel U, Bauer C, Gerhard I, et al. Adjuvante simultane Mistel−/Chemotherapie bei Mammakarzinom–Einfluss auf Immunparameter, Lebensqualität und Verträglichkeit. Complement Med Res. 2008;15(1):22–30.

    Google Scholar 

  43. 43.

    Longhi A, Mariani E, Kuehn JJ. A randomized study with adjuvant mistletoe versus oral Etoposide on post relapse disease-free survival in osteosarcoma patients. Eur J Integr Med. 2009;1(1):31–9.

    Google Scholar 

  44. 44.

    Piao BK, Wang YX, Xie GR, Mansmann U, Matthes H, Beuth J, et al. Impact of complementary mistletoe extract treatment on quality of life in breast, ovarian and non-small cell lung cancer patients. A prospective randomized controlled clinical trial. Anticancer Res. 2004;24(1):303–9.

    CAS PubMed Google Scholar 

  45. 45.

    Semiglasov VF, Stepula VV, Dudov A, Lehmacher W, Mengs U. The standardised mistletoe extract PS76A2 improves QoL in patients with breast cancer receiving adjuvant CMF chemotherapy: a randomised, placebo-controlled, double-blind, multicentre clinical trial. Anticancer Res. 2004;24(2C):1293–302.

    CAS PubMed Google Scholar 

  46. 46.

    Semiglazov VF, Stepula VV, Dudov A, Schnitker J, Mengs U. Quality of life is improved in breast cancer patients by standardised mistletoe extract PS76A2 during chemotherapy and follow-up: a randomised, placebo-controlled, double-blind, multicentre clinical trial. Anticancer Res. 2006;26(2B):1519–29.

    CAS PubMed Google Scholar 

  47. 47.

    Steuer-Vogt M, Bonkowsky V, Scholz M, Fauser C, Licht K, Ambrosch P. Influence of ML-1 standardized mistletoe extract on the quality of life in head and neck cancer patients. Hno. 2006;54(4):277–86.

    CAS PubMed Google Scholar 

  48. 48.

    Tröger W, Jezdic S, Zdrale Z, Tisma N, Hamre HJ, Matijasevic M. Quality of life and neutropenia in patients with early stage breast cancer: a randomized pilot study comparing additional treatment with mistletoe extract to chemotherapy alone. Breast Cancer. 2009;3(1):35–45.

  49. 49.

    Tröger W, Zdrale Z, Tisma N, Matijasevic M. Additional therapy with a mistletoe product during adjuvant chemotherapy of breast cancer patients improves quality of life: an open randomized clinical pilot trial. Evid Based Complement Alternat Med. 2014a;2014: 430518. https://doi.org/10.1155/2014/430518.

  50. 50.

    Tröger W, Galun D, Reif M, Schumann A, Stanković N, Milićević M. Quality of life of patients with advanced pancreatic cancer during treatment with mistletoe: a randomized controlled trial. Deutsches Ärzteblatt International. 2014b;111(29–30):493–502 33 p following.

    PubMed PubMed Central Google Scholar 

  51. 51.

    Tröger W, Galun D, Reif M, Schumann A, Stankovic N, Milicevic M. Quality of life of patients with advanced pancreatic cancer during treatment with mistletoe: a randomized controlled trial. Dtsch Arztebl Int. 2014;111(29–30):493.

    PubMed PubMed Central Google Scholar 

  52. 52.

    Longhi A, Reif M, Mariani E, Ferrari S. A randomized study on postrelapse disease-free survival with adjuvant mistletoe versus oral etoposide in osteosarcoma patients. Evid Based Complement Alternat Med. 2014;2014:210198. https://doi.org/10.1155/2014/210198.

  53. 53.

    von Rohr E, Pampallona S, van Wegberg B, Cerny T, Hürny C, Bernhard J, et al. Attitudes and beliefs towards disease and treatment in patients with advanced cancer using anthroposophical medicine. Oncol Res Treat. 2000;23(6):558–63.

    Google Scholar 

  54. 54.

    Beadle GF, Yates P, Najman JM, Clavarino A, Thomson D, Williams G, et al. Illusions in advanced cancer: the effect of belief systems and attitudes on quality of life. Psycho-Oncol. 2004;13(1):26–36.

    CAS Google Scholar 

  55. 55.

    Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers; 1988.

    Google Scholar 

  56. 56.

    Osoba D, Rodrigues G, Myles J, Zee B, Pater J. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol. 1998;16(1):139–44.

    CAS PubMed Google Scholar 

  57. 57.

    Cella D, Eton DT, Fairclough DL, Bonomi P, Heyes AE, Silberman C, et al. What is a clinically meaningful change on the functional assessment of Cancer therapy–lung (FACT-L) questionnaire?: results from eastern cooperative oncology group (ECOG) study 5592. J Clin Epidemiol. 2002;55(3):285–95.

    PubMed Google Scholar 

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Acknowledgments

Not applicable.

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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Contributions

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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Correspondence to Harald Walach.

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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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