Reference Citation(s)	Type of Study	Type(s) of Cancer	No. of Patients: Enrolled; Treated; Controlb	Strongest Benefit Reportedc	Concurrent Therapyd	Level of Evidence Scoree
[5]	Randomized trial	Bladder, noninvasive	45; 23; 22	None	No	1iiDi
[1,3]	Randomized trial	Brain, glioma; 74% of patients, stages III–IV; 26% of patients, no stage information	47; 20; 18	Improved survival, stages III–IV patients only	Yes	1iiA
[22]	Randomized trial	Breast, metastatic	46; 21; 19f	Improved quality of life	Yesg	1iiC
[31,34]	Randomized trial	Colorectal, metastatic	107; 38; 41	Improved quality of life	Yes	1iiA
[4]	Randomized trial	Head and neck, squamous cell, stages I–IV	495; 235h; 242h	None	Yesh	1iiA
[6]	Phase I/II trial	Pancreas, stages III–IV	16; 16; None	Stabilized quality of life	No	3iiiC

No. = number.

aSee text and the NCI Dictionary for additional information and definition of terms.

bNumber of patients treated plus number of patients controlled may not equal number of patients enrolled; number of patients enrolled = number of patients initially recruited/considered by the researchers who conducted a study; number of patients treated = number of enrolled patients who were administered the treatment being studied AND for whom results were reported; historical control subjects are not included in number of patients enrolled.

cStrongest evidence reported that the treatment under study has anticancer activity or otherwise improves the well-being of cancer patients.

dChemotherapy, radiation therapy, hormonal therapy, or cytokine therapy administered/allowed at the same time as mistletoe therapy.

eFor information about levels of evidence analysis and an explanation of the level of evidence scores, see Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.

fControl patients were treated with a saline solution as a placebo.

gAll patients in this trial were treated with palliative chemotherapy (vindesine, epirubicin, and cyclophosphamide); chemotherapy and Eurixor were administered concurrently.

hThis trial was a four-arm trial; patients were randomly assigned to surgery only or to surgery plus radiation therapy, followed by a second randomization to no mistletoe treatment or to treatment with Eurixor; the resulting treatment groups contained the following numbers of evaluable patients: surgery only = 105, surgery plus Eurixor = 97, surgery plus radiation therapy = 137, and surgery plus radiation therapy plus Eurixor = 138; radiation therapy and Eurixor treatment overlapped; no treatment approach was superior in terms of disease-free survival, disease-specific survival, improvement in quality of life, or stimulation of the immune system; in the table, mistletoe-treated and nontreated (control) patients were grouped (i.e., number treated = 97 + 138 = 235, and number control = 105 + 137 = 242).

References

1. Lenartz D, Stoffel B, Menzel J, et al.: Immunoprotective activity of the galactoside-specific lectin from mistletoe after tumor destructive therapy in glioma patients. Anticancer Res 16 (6B): 3799-802, 1996 Nov-Dec.  [PUBMED Abstract]
   
   
3. Lenartz D, Dott U, Menzel J, et al.: Survival of glioma patients after complementary treatment with galactoside-specific lectin from mistletoe. Anticancer Res 20 (3B): 2073-6, 2000 May-Jun.  [PUBMED Abstract]
   
   
4. Steuer-Vogt MK, Bonkowsky V, Ambrosch P, et al.: The effect of an adjuvant mistletoe treatment programme in resected head and neck cancer patients: a randomised controlled clinical trial. Eur J Cancer 37 (1): 23-31, 2001.  [PUBMED Abstract]
   
   
5. Goebell PJ, Otto T, Suhr J, et al.: Evaluation of an unconventional treatment modality with mistletoe lectin to prevent recurrence of superficial bladder cancer: a randomized phase II trial. J Urol 168 (1): 72-5, 2002.  [PUBMED Abstract]
   
   
6. Friess H, Beger HG, Kunz J, et al.: Treatment of advanced pancreatic cancer with mistletoe: results of a pilot trial. Anticancer Res 16 (2): 915-20, 1996 Mar-Apr.  [PUBMED Abstract]
   
   
22. Heiny BM: [Adjuvant therapy with standardized mistletoe extract reduces leukopenia and improves the quality of life of patients with advanced breast cancer under palliative chemotherapy (VEC regimen)]. Krebsmedizin 12: 1-14, 1991. 
    
    
31. Heiny BM, Albrecht V, Beuth J: Stabilization of quality of life with mistletoe lectin-1-standardized extract in advanced colorectal carcinoma. Onkologe 4 (Suppl 1): S35-9, 1998. 
    
    
34. Sauer H: Quality of life stabilization with mistletoe-1-standardized extract in advanced colorectal carcinoma [Letter]. Onkologe 4: 1180, 1998.