Safety of anthroposophic supportive treatment in children with medulloblastoma receiving first-line therapy

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=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=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.

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