von Schoen-Angerer Tido, Goyert Andreas, Vagedes Jan, Kiene Helmut, Merckens Harald, Kienle Gunver S
ARCIM Institute, Filderklinik, Filderstadt, Germany;Dept of Pediatrics, Fribourg Hospital HFR, Fribourg, Switzerland.
Dept of Internal Medicine, Filderklinik, Filderstadt, Germany.
J Gastrointestin Liver Dis. 2014 Dec;23(4):449-52. doi: 10.15403/jgld.2014.1121.234.acpy.
Extracts of Viscum album (European mistletoe) have immune-stimulatory and cytotoxic effects, with trials showing a well-established effect on the quality of life and prolonged survival in patients with advanced pancreatic cancer. Regression of tumours following intratumoural injection with Viscum album extract has been documented in individual cases. However, its influence on colon polyps has not been investigated.
We present the case of a 78-year-old Caucasian male who had undergone hemi-colectomy for a stage IIIC colon cancer but who refused adjuvant chemotherapy. Five years later a newly detected high-grade dysplasia colon adenoma was discovered; however, the adenoma could not be resected endoscopically and the patient did not consent to surgery. Intratumoural injections with Viscum album L extract (Quercus; Iscador®Qu) were administered twice in an attempt to limit tumour growth. Eight months after the second intratumoural injection the adenoma had disappeared and biopsy revealed no intraepithelial dysplasia or adenoma.
This is the first report showing complete regression of a colon adenoma after intratumoural injection with Viscum album extract. Prospective studies should evaluate if the treatment effect is reproducible and if this approach could be a useful pre-operative measure for colon adenomas too large for endoscopic resection.
欧洲槲寄生提取物具有免疫刺激和细胞毒性作用，试验表明其对晚期胰腺癌患者的生活质量和延长生存期有确切效果。个别病例记录显示，瘤内注射欧洲槲寄生提取物后肿瘤出现消退。然而，其对结肠息肉的影响尚未得到研究。
我们报告一例78岁白种男性病例，该患者因IIIC期结肠癌接受了半结肠切除术，但拒绝辅助化疗。五年后发现一个新的高级别发育异常结肠腺瘤；然而，该腺瘤无法通过内镜切除，且患者不同意手术。为限制肿瘤生长，进行了两次瘤内注射欧洲槲寄生提取物（栎属；艾斯卡多®栎）。第二次瘤内注射八个月后，腺瘤消失，活检未发现上皮内发育异常或腺瘤。
这是首例关于瘤内注射欧洲槲寄生提取物后结肠腺瘤完全消退的报告。前瞻性研究应评估该治疗效果是否可重复，以及这种方法是否可作为内镜切除过大的结肠腺瘤的有用术前措施。
