Troger, W., Galun, D., Reif, M., Schumann, A., Stankovic, N., & Milicevic, M. (2014). Quality of life of patients with advanced pancreatic cancer during treatment with mistletoe: A randomized controlled trial. Deutsches Arzteblatt International, 111, 493–502, 33 p following 502.
To evaluate the impact of mistletoe extract injections on overall survival and quality of life in patients with advanced pancreatic cancer
Escalating doses of mistletoe extract were self-administered by patients as a 1 ml subcutaneous injection three times a week for the duration of the trial (up to one year) by the patient, a family member, or the local treatment center staff. The dose was escalated as follows: 0.01 mg for two injections, 0.1 mg for two injections, 1 mg for five injections, 2 mg for five injections, 5 mg for eight injections, and 10 mg for the remainder of the injections. Patients were evaluated by completing the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) at seven timepoints (at enrollment and before each visit in months 1, 2, 3, 6, 9, and 12). Patients were evaluated by the physician at each visit for the severity of symptoms of cancer (including weight loss) and undesired events.
Prospective, randomized trial (randomized 1:1 ratio to mistletoe injections or control after stratification for prognosis of good or poor)
All questionnaires were evaluated at the end of the trial. The treatment group received a median of 61.5 mistletoe injections. The treatment improved the global quality of life with statistical significance (p < 0.001) for global quality of life, appetite loss, fatigue, pain, and nausea at various follow-up time periods. The number of questionnaires received at various time points in the study ranged from 0–110 in the control group and 19–110 in the mistletoe group. The number of documented injections ranged from 3–156 per patient. No side effects were reported. The trial was terminated early because of demonstrated efficacy.
The results of the patient-completed quality of life questionnaires were reported with improvements in 13 of the 15 scales in the group treated with mistletoe. The administration of mistletoe was associated with improvements in appetite loss, fatigue, and pain.
The findings of this study suggest that mistletoe may be beneficial to patients with advanced cancer for multiple symptoms. The positive findings of this study suggest that additional research in this area is warranted.