Z Gastroenterol 2007; 45 - P046
DOI: 10.1055/s-2007-988193

Treatment with standardized mistletoe extract (Viscum album L.) Iscador® as a part of long-term supportive care in patients with primary non-metastatic colorectal carcinoma

E Friedel 1, H Matthes 2, P Bock 3
  • 1Hospital Bad Bocklet, Dept. of Internal Medicine and Oncology, Bad Bocklet, Germany
  • 2Hospital Havelhöhe, Oncology Clinic, Berlin, Germany
  • 3Institute for Applied Medical Research, IFAG, Basel, Switzerland

Aims: Mistletoe therapy is a frequently used supportive treatment in cancer patients to improve quality of life and baseline therapy induced adverse events.

Objectives: To evaluate efficacy and safety of the standardized mistletoe extract Iscador® (ISC) in supportive care of surgically treated patients with primary non-metastatic colorectal carcinoma in comparison with a parallel control group without ISC.

Methods: In a multicenter, epidemiological, observational cohort study in Germany and Switzerland, ISC was given in addition to conventional adjuvant chemo- and radiotherapy, and the control was treated with conventional therapy only. Endpoints were surrogates of quality of life and the survival, adjusted to baseline imbalance, therapy regimen and other confounders.

Results: In 804 (429 ISC and 375 control) evaluable patients from 26 centers, most of the baseline characteristics, prognostic criteria, and therapy was sufficiently balanced between the groups. After a median follow up of 61 vs. 56 months, and a median ISC therapy duration of 53 months, significantly fewer ISC (19.1%) than control patients (48.3%) developed ADRs by the conventional therapy (p<0.001), had fewer, mainly gastrointestinal and CNS, symptoms during the therapy (p ≤0.001), and on average one week shorter hospitalization (p=0.004). ISC vs. control patients showed a longer tumor-free survival (p=0.026). In the ISC group 2,3% of the patients developed treatment systemic reactions and 23,3% had local reactions at the injection site. Severe ISC-related ADRs or tumor enhancement were not observed.

Conclusions: The ISC-group showed significantly fewer ADRs of the conventional therapy, disease- and therapy-related symptoms, and longer tumor-free survival than the parallel control group. ISC-treatment was well tolerated and appears beneficial in the supportive care in primary non-metastatic colorectal carcinoma.