Mistletoe in oncological treatment: a systematic review

Part 1: survival and safety

Abstract

Purpose

Mistletoe treatment of cancer patients is discussed highly controversial in the scientific literature. Aim of this systematic review is to give an extensive overview about current state of research concerning mistletoe therapy of oncologic patients regarding survival, quality of life and safety.

Methods

In September and October 2017 Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL and “Science Citation Index Expanded” (Web of Science) were systematically searched.

Results

The search strategy identified 3647 hits and 28 publications with 2639 patients were finally included in this review. Mistletoe was used in bladder cancer, breast cancer, other gynecological cancers (cervical cancer, corpus uteri cancer, and ovarian cancer), colorectal cancer, other gastrointestinal cancer (gastric cancer and pancreatic cancer), glioma, head and neck cancer, lung cancer, melanoma and osteosarcoma. In nearly all studies, mistletoe was added to a conventional therapy. Patient relevant endpoints were overall survival (14 studies, n = 1054), progression- or disease-free survival or tumor response (10 studies, n = 1091). Most studies did not show any effect of mistletoe on survival. Especially high quality studies do not show any benefit.

Conclusions

With respect to survival, a thorough review of the literature does not provide any indication to prescribe mistletoe to patients with cancer.

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Fig. 1

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Acknowledgements

The authors want to thank Dajana Daum, Catalina Hoppe, Gunnar Voß and Louisa Wortmann for supporting in data extraction/data management and duplicate search.

Funding

The work of MF was funded in parts (search of the literature, title-abstract screening) by the German Guideline “S3 Leitlinie Komplementärmedizin in der Behandlung von onkologischen PatientInnen (Registernummer 032–055OL)” funded by the German Cancer Aid (Fördernummer 11583) within the German Guideline Program in Oncology. Furthermore, the work of MF was funded in parts (evidence table) by the working group Prevention and Integrative Oncology of the German Cancer Society.

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Correspondence to Jutta Huebner.

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Freuding, M., Keinki, C., Micke, O. et al. Mistletoe in oncological treatment: a systematic review. J Cancer Res Clin Oncol 145, 695–707 (2019). https://doi.org/10.1007/s00432-018-02837-4

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Keywords

  • Mistletoe
  • Cancer
  • Complementary and alternative medicine (CAM)
  • Patient-relevant outcomes