CHS-Institut, Schönwalder Str. 17, D-13347, Berlin, Germany.
Department Pediatric Gastroenterology, Poznan Medical University, Poznan, Poland.
BMC Complement Med Ther. 2020 Jul 20;20(1):227. doi: 10.1186/s12906-020-03013-3.
Mistletoe extracts are used as an adjunct therapy for cancer patients, but there is dissent as to whether this therapy has a positive impact on quality of life (QoL).
We conducted a systematic review searching in several databases (Medline, Embase, CENTRAL, CINAHL, PsycInfo, Science Citation Index, clinicaltrials.gov, opengrey.org ) by combining terms that cover the fields of "neoplasm", "quality of life" and "mistletoe". We included prospective controlled trials that compared mistletoe extracts with a control in cancer patients and reported QoL or related dimensions. The quality of the studies was assessed with the Cochrane Risk of Bias tool version 2. We conducted a quantitative meta-analysis.
We included 26 publications with 30 data sets. The studies were heterogeneous. The pooled standardized mean difference (random effects model) for global QoL after treatment with mistletoe extracts vs. control was d = 0.61 (95% CI 0.41-0.81, p < 0,00001). The effect was stronger for younger patients, with longer treatment, in studies with lower risk of bias, in randomized and blinded studies. Sensitivity analyses support the validity of the finding. 50% of the QoL subdomains (e.g. pain, nausea) show a significant improvement after mistletoe treatment. Most studies have a high risk of bias or at least raise some concern.
Mistletoe extracts produce a significant, medium-sized effect on QoL in cancer. Risk of bias in the analyzed studies is likely due to the specific type of treatment, which is difficult to blind; yet this risk is unlikely to affect the outcome.
CRD42019137704 .
槲寄生提取物被用作癌症患者的辅助治疗方法，但对于这种治疗方法是否对生活质量（QoL）有积极影响存在分歧。
我们通过结合涵盖“肿瘤”、“生活质量”和“槲寄生”领域的术语，在多个数据库（Medline、Embase、CENTRAL、CINAHL、PsycInfo、Science Citation Index、clinicaltrials.gov、opengrey.org）中进行了系统综述搜索。我们纳入了比较槲寄生提取物与癌症患者对照的前瞻性对照试验，并报告了 QoL 或相关维度。研究质量使用 Cochrane 风险偏倚工具版本 2 进行评估。我们进行了定量荟萃分析。
我们纳入了 26 篇出版物，共 30 个数据集。这些研究存在异质性。与对照组相比，使用槲寄生提取物治疗后的全球 QoL 的 pooled 标准化均数差（随机效应模型）为 d=0.61（95% CI 0.41-0.81，p<0.00001）。对于年轻患者、治疗时间较长、风险较低的研究、随机和盲法研究，效果更强。敏感性分析支持这一发现的有效性。50%的 QoL 亚域（如疼痛、恶心）在槲寄生治疗后有显著改善。大多数研究的风险偏倚较高，或者至少存在一些问题。
槲寄生提取物对癌症患者的 QoL 产生显著的中等效应。分析研究中的风险偏倚可能是由于难以进行盲法的特定治疗类型所致；然而，这种风险不太可能影响结果。
PROSPERO 注册号：CRD42019137704。
