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Safety of anthroposophic supportive treatment in children with medulloblastoma receiving first-line therapy
ARTICLE IN PRESS 204
Abstracts / European Journal of Integrative Medicine 1 (2009) 181–221
OP-012 Safety of anthroposophic supportive treatment in children with medulloblastoma receiving first-line therapy G. Seiferta, P. Jessea, M. Reifb, S. Rutkowskyc, R. Madeleynd, G. Henzea, A. La¨nglere, S. Rutkowskyc, G. Seiferta, P. Jessea, M. Reifb, S. Rutkowskyc, R. Madeleynd, G. Henzea, A. La¨nglere, S. Rutkowskyc a
Charite´-Universita¨tsmedizin Berlin, Pediatric Oncology and Hematology, Berlin, Germany b Institute for Clinical Research (IKF Berlin), Berlin, Germany c University of Wuerzburg, Children’s University Hospital, Wu¨rzburg, Germany d Filderklinik, Department of Paediatrics, Stuttgart, Germany e Gemeinschaftskrankenhaus Herdecke, Department of Paediatrics, Herdecke, Germany
Background: The use of anthroposophic medicine (AM) is popular in Central Europe, especially in German-speaking countries. A survey regarding AM use in pediatric oncology in Germany estimates its prevalence among CAM users to be about 30%. Although these therapies are judged to be beneficial by many patients, there exist no data concerning safety and efficacy in this population. Several theoretical concerns have been published regarding tumor enhancement or promotion of metastatic dissemination. To test the safety of supportive anthroposophic treatment accompanying the first-line treatment in children with medulloblastoma, we performed a retrospective matched pair analysis of 17 patients with medulloblastoma treated concomitantly with a panel of anthroposophic medicines (AM) including mistletoe. All patients were treated according to the treatment protocols of the German HIT study group. Methods: There were 12 male patients and 5 female patients, with a median age of 6.2 years (interquartile 4.1–7.3, range 1.8–15.7). The supportive anthroposophic treatment was given by pediatricians with specialized training in anthroposophic medicine. All patients underwent tumor resection followed by postoperative radiation and chemotherapy. The patients with AM were matched in a 1:2 ratio with 34 patients from the database of the German HIT study group with regard to the criteria diagnosis, age, status of metastatic dissemination, resection status and first-line therapy. Results: The overall survival after 10 years was 58.33% for the AM group and 57.14% for the control group, i.e. showing only a marginal non-significant difference (stratified Cox regression, p ¼ 0.6023). Six medulloblastoma patients with AM had local tumor recurrences and 3 died due to tumor progression. In the control
group 8 medulloblastoma patients had a local tumor recurrence and 7 patients died due to tumor progression. Event-free survival (including metastases) also did not differ between the groups (stratified Cox regression, p ¼ 0.4275). Conclusions: Anthroposophic medicine consisting of different combinations of specific pharmacological and non-pharmacological interventions appears to be safe with respect to the first-line therapy. There is no evidence regarding tumor enhancement. The effectiveness of the supportive AM cannot be assessed based on these data. 10.1016/j.eujim.2009.08.112
OP-031 Anthroposophic medicine in paediatric oncology in Germany: Results of a population-based retrospective parental survey A. Laenglera,b, C. Spixa,b, F. Edelha¨usera,b, D. Martina,b, G. Kamedaa,b, P. Kaatscha,b, G. Seiferta,b a
Gemeinschaftskrankenhaus, Pediatrics, Herdecke, Germany b Universita¨t Witten Herdecke, Gerhard Kienle Lehrstuhl fu¨r Antrhoposophische und Integrative Medizin, Witten, Germany
Introduction: Anthroposophic medicine (AM) as a CAM treatment is used frequently in German-speaking countries. Based on a retrospective parental questionnaire, this study presents results of a comparison between AM-users and users of other complementary and alternative medical treatment methods (CAM) in paediatric oncology in Germany. The differences between these two groups are investigated with respect to CAM-use behaviour, surrounding circumstances and previous experience of CAM. Results: Of the 367 CAM-users 98 (27%) patients employed anthroposophic treatments or therapies. Treatment duration amounted to a median 619 days for AM and 225 days for other CAM treatments. All parents with previous experience of AM also used AM for treatment of their child’s cancer disease. AM-users had a higher social status. Physicians of AM-users played a more relevant role both in procuring information (24% vs. 11%) and in prescribing medicines and therapies (73.5% vs. 34.9%). AM-users communicate more frequently with their physicians about the use of CAM treatments (89.8% vs. 63.9%) and recommend AM more often than other CAM-users recommend other CAM therapies (95.9% vs. 87%).
Abstracts / European Journal of Integrative Medicine 1 (2009) 181–221
OP-012 Safety of anthroposophic supportive treatment in children with medulloblastoma receiving first-line therapy G. Seiferta, P. Jessea, M. Reifb, S. Rutkowskyc, R. Madeleynd, G. Henzea, A. La¨nglere, S. Rutkowskyc, G. Seiferta, P. Jessea, M. Reifb, S. Rutkowskyc, R. Madeleynd, G. Henzea, A. La¨nglere, S. Rutkowskyc a
Charite´-Universita¨tsmedizin Berlin, Pediatric Oncology and Hematology, Berlin, Germany b Institute for Clinical Research (IKF Berlin), Berlin, Germany c University of Wuerzburg, Children’s University Hospital, Wu¨rzburg, Germany d Filderklinik, Department of Paediatrics, Stuttgart, Germany e Gemeinschaftskrankenhaus Herdecke, Department of Paediatrics, Herdecke, Germany
Background: The use of anthroposophic medicine (AM) is popular in Central Europe, especially in German-speaking countries. A survey regarding AM use in pediatric oncology in Germany estimates its prevalence among CAM users to be about 30%. Although these therapies are judged to be beneficial by many patients, there exist no data concerning safety and efficacy in this population. Several theoretical concerns have been published regarding tumor enhancement or promotion of metastatic dissemination. To test the safety of supportive anthroposophic treatment accompanying the first-line treatment in children with medulloblastoma, we performed a retrospective matched pair analysis of 17 patients with medulloblastoma treated concomitantly with a panel of anthroposophic medicines (AM) including mistletoe. All patients were treated according to the treatment protocols of the German HIT study group. Methods: There were 12 male patients and 5 female patients, with a median age of 6.2 years (interquartile 4.1–7.3, range 1.8–15.7). The supportive anthroposophic treatment was given by pediatricians with specialized training in anthroposophic medicine. All patients underwent tumor resection followed by postoperative radiation and chemotherapy. The patients with AM were matched in a 1:2 ratio with 34 patients from the database of the German HIT study group with regard to the criteria diagnosis, age, status of metastatic dissemination, resection status and first-line therapy. Results: The overall survival after 10 years was 58.33% for the AM group and 57.14% for the control group, i.e. showing only a marginal non-significant difference (stratified Cox regression, p ¼ 0.6023). Six medulloblastoma patients with AM had local tumor recurrences and 3 died due to tumor progression. In the control
group 8 medulloblastoma patients had a local tumor recurrence and 7 patients died due to tumor progression. Event-free survival (including metastases) also did not differ between the groups (stratified Cox regression, p ¼ 0.4275). Conclusions: Anthroposophic medicine consisting of different combinations of specific pharmacological and non-pharmacological interventions appears to be safe with respect to the first-line therapy. There is no evidence regarding tumor enhancement. The effectiveness of the supportive AM cannot be assessed based on these data. 10.1016/j.eujim.2009.08.112
OP-031 Anthroposophic medicine in paediatric oncology in Germany: Results of a population-based retrospective parental survey A. Laenglera,b, C. Spixa,b, F. Edelha¨usera,b, D. Martina,b, G. Kamedaa,b, P. Kaatscha,b, G. Seiferta,b a
Gemeinschaftskrankenhaus, Pediatrics, Herdecke, Germany b Universita¨t Witten Herdecke, Gerhard Kienle Lehrstuhl fu¨r Antrhoposophische und Integrative Medizin, Witten, Germany
Introduction: Anthroposophic medicine (AM) as a CAM treatment is used frequently in German-speaking countries. Based on a retrospective parental questionnaire, this study presents results of a comparison between AM-users and users of other complementary and alternative medical treatment methods (CAM) in paediatric oncology in Germany. The differences between these two groups are investigated with respect to CAM-use behaviour, surrounding circumstances and previous experience of CAM. Results: Of the 367 CAM-users 98 (27%) patients employed anthroposophic treatments or therapies. Treatment duration amounted to a median 619 days for AM and 225 days for other CAM treatments. All parents with previous experience of AM also used AM for treatment of their child’s cancer disease. AM-users had a higher social status. Physicians of AM-users played a more relevant role both in procuring information (24% vs. 11%) and in prescribing medicines and therapies (73.5% vs. 34.9%). AM-users communicate more frequently with their physicians about the use of CAM treatments (89.8% vs. 63.9%) and recommend AM more often than other CAM-users recommend other CAM therapies (95.9% vs. 87%).