Mistletoe in oncological treatment: a systematic review

Part 2: quality of life and toxicity of cancer treatment

Abstract

Purpose

One important goal of any cancer therapy is to improve or maintain quality of life. In this context, mistletoe treatment is discussed to be highly controversial. The aim of this systematic review is to give an extensive overview about the current state of evidence concerning mistletoe therapy of oncologic patients regarding quality of life and side effects of cancer treatments.

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 articles 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. Regarding quality of life, 17 publications reported results. Studies with better methodological quality show less or no effects on quality of life.

Conclusions

With respect to quality of life or reduction of treatment-associated side effects, a thorough review of the literature does not provide any indication to prescribe mistletoe to patients with cancer.

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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., Kutschan, S. et al. Mistletoe in oncological treatment: a systematic review. J Cancer Res Clin Oncol 145, 927–939 (2019). https://doi.org/10.1007/s00432-018-02838-3

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Keywords

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