IMMUNOTHERAPY WITH VISCUM ALBUM EXTRACT IN THE TREATMENT OF ADVANCED COLORECTAL CANCER

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[学科分类] 外科医学

[关键词] Background: Most clinical trials using mistletoe to treat colorectal cancer are out-of-date and have major methodological weaknesses that raise doubts about their findings. Meanwhile;the arsenal of chemotherapy has much evolved over the last decade. Thus;the aim of this study was to determine the effectiveness of the total plant extract Isorel in association with modern chemotherapy in the treatment of colorectal cancer. Methods: After the surgical removal of the primary tumor;a total of 124 patients with advanced colorectal cancer (stage Dukes C and D);were randomly divided into the immunotherapy group (Isorel associated in most of the cases with chemotherapy;n=58) and the control group (most of which received chemotherapy). The chemotherapy regimens were based on 5-fluorouracil;irinotecan and oxaliplatin. Overall survival and adverse events were observed. Results: The addition of immunotherapy with Viscum album extract Isorel to 5FU-based chemotherapy significantly improved overall survival in Dukes stage C (5-year survival: 46% vs. 17%;median survival: 46 vs. 24 months;p=0.004) and D (median survival: 13;5 vs. 9;5 months;p=0.02;longest survival:26 vs. 12 months). The addition of immunotherapy to oxaliplatin- and irinotecan-based chemotherapy further improved overall survival in Dukes stage C (5-year survival: 64% vs. 38%;median survival: 57;5 vs. 34 months;p=0.04) and D (median survival: 24 vs. 18 months;p=0.02;longest survival:36 vs. 24 months). Inflammatory local reactions at the s.c. injection site occur frequently (83% of patients) at the beginning of the treatment for 1 to 8 weeks. Conclusions: Immunotherapy with Viscum album extract Isorel;added to chemotherapy;improves the survival of the patients operated for advanced colorectal cancer compared with chemotherapy alone;whatever its type.