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omplementary Therapies in Medicine (2014) 22, 320—332

Available online at www.sciencedirect.com

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j ourna l ho me pa g e: www.elsev ierhea l th .com/ journa ls /c t im

dditive homeopathy in cancer patients:etrospective survival data from aomeopathic outpatient unit at the Medicalniversity of Vienna

atharina Gaertnera,b, Michael Müllnera, Helmut Friehsa,rnst Schusterc, Christine Marosi a, Ilse Muchitsche,ichael Frassa,d, Alan David Kayef,∗

Medical University Vienna, Department of Medicine I, Clinical Division of Oncology, Waehringer Guertel8-20, 1090 Vienna, AustriaInstitute of Complementary Medicine, Medical University Bern, Inselspital, 3010 Bern, SwitzerlandMedical University of Vienna, Center for Medical Statistics, Informatics, and Intelligent Systems,ienna, AustriaWissHom (Scientific Society for Homeopathy), Köthen, Germany1

Austrian Chamber of Pharmacists, Department Vienna, AustriaDepartment of Anesthesiology and Department of Pharmacology, Louisiana State University Schoolf Medicine Health Sciences Center, New Orleans, LA, United Statesvailable online 8 January 2014

KEYWORDSHomeopathy;Cancer;Glioblastoma;Lung;Cholangiocellularcancer;

SummaryBackground: Current literature suggests a positive influence of additive classical homeopathyon global health and well-being in cancer patients. Besides encouraging case reports, thereis little if any research on long-term survival of patients who obtain homeopathic care duringcancer treatment.Design: Data from cancer patients who had undergone homeopathic treatment complementaryto conventional anti-cancer treatment at the Outpatient Unit for Homeopathy in Malignant

Pancreatic Diseases, Medical University Vienna, Department of Medicine I, Vienna, Austria, were collected,

described and a retrospective subgroup-analysis with regard to survival time was performed. carcinomas;

Metastasizedsarcoma;Renal cell carcinoma

Patient inclusion criteria were at least three homeopathic consultations, fatal prognosis ofdisease, quantitative and qualitative description of patient characteristics, and survival time.Results: In four years, a total of 538 patients were recorded to have visited the OutpatientUnit Homeopathy in Malignant Diseases, Medical University Vienna, Department of Medicine

∗ Corresponding author at: Department of Anesthesiology, Louisiana State University School of Medicine, 1542 Tulane Avenue, Room 656,ew Orleans, LA 70112, United States. Tel.: +1 504 568 2319; fax: +1 504 568 2317.

E-mail addresses: akaye@lsuhsc.edu, alankaye44@hotmail.com (A.D. Kaye).1 www.wisshom.de.

965-2299/$ — see front matter © 2014 Elsevier Ltd. All rights reserved.ttp://dx.doi.org/10.1016/j.ctim.2013.12.014

Additive homeopathic care in cancer patients 321

I, Vienna, Austria. 62.8% of them were women, and nearly 20% had breast cancer. From the 53.7%(n = 287) who had undergone at least three homeopathic consultations within four years, 18.7%(n = 54) fulfilled inclusion criteria for survival analysis. The surveyed neoplasms were glioblas-toma, lung, cholangiocellular and pancreatic carcinomas, metastasized sarcoma, and renal cellcarcinoma. Median overall survival was compared to expert expectations of survival outcomesby specific cancer type and was prolonged across observed cancer entities (p < 0.001).Conclusion: Extended survival time in this sample of cancer patients with fatal prognosis butadditive homeopathic treatment is interesting. However, findings are based on a small sample,and with only limited data available about patient and treatment characteristics. The relationshipbetween homeopathic treatment and survival time requires prospective investigation in larger

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Survival time was compared with ‘‘expected survivaltime’’ in each patient. Expectations were calculated fromdata found in literature. These were considered as such:

samples possibly using match© 2014 Elsevier Ltd. All right

Introduction

The use of homeopathy to enhance wellness in society,as well as in clinical settings, is increasing.1—4 Yet, home-opathic methods are often considered controversial, andtheir effects have not been tested adequately by conven-tional study designs.2,5—8 Nonetheless, there are suggestionsthat the use of complementary and alternative medicine(CAM) and homeopathy in particular is especially high inpatients with chronic diseases,9 such as cancer. In Europe,unlike in the United States,10 homeopathy is one of themost common CAM-therapies used in cancer. It is reportedto be used in 12—24% of cancer patients.11,12 Studies havedocumented relief of adverse drug reactions and betterhealth-related quality of life in cancer patients with addi-tive homeopathic treatment.13 These conclusions are basedlargely on case reports and limited data regarding patientsurvival is limited.14—17

The present study was prompted by anecdotal impres-sions suggesting that glioblastoma patients provided sup-plemental homeopathic treatment experienced extendedsurvival times at the Outpatient Unit for Homeopathy inMalignant Diseases at the Department of Medicine I, MedicalUniversity of Vienna, Austria. To determine whether theseimpressions were reliable, a retrospective data analysis wasperformed. The specific aim was to test the predictive valuefor forthcoming trials on survival time of cancer patients,treated complementarily with homeopathy compared withaverage life expectancy. Alongside the analysis targets adescription of patients attending the Unit.

Materials and methods

The study was approved by the Ethical Committee ofthe Medical University Vienna. Recruitment involved ret-rospective manual data collection from patient records atthe Outpatient Unit ‘‘Homeopathy in Malignant Diseases’’,Medical University of Vienna and the university hospitals’documentary system. Data were processed in three steps:Characteristics (e.g. name, age, sex, and tumor entity) anddates of homeopathic consultations from all patients withthe first consultation between March 2004 and March 2008were noted in Excel tables (group 1; n = 538). In a second

step, data from the patients with at least three homeo-pathic consultations (group 2; n = 287) were completed withexact time of diagnosis, start, times, and kind of conven-tional treatment as well as date of death, if recorded. They

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air control analysis or randomized trials.erved.

ere grouped and statistically described. Those patientsith fatal tumor prognosis and a sample size of at least 5atients were analyzed regarding their survival times (group; n = 54). Follow-up time was 54—66 months. Conventionalnti-cancer care was administered by cancer experts athe Medical University of Vienna. At the time of treat-ent, all cancer patients received up-to-date therapy for

heir disease process. Homeopathic treatment consisted of first consultation of 90 min and follow-up meetings of0 min every 8—12 weeks. Individualized, Q-potentized18

ilutions were prescribed by a licensed homeopath in accor-ance with the method of homeopathic cancer treatmenteveloped in the Clinica Santa Croce, Locarno, Italy.16

n case of acute conditions, patients received addition-lly C-potentized18 single-doses. All homeopathic remediesere prepared at the Maria Treu Apotheke, Vienna, Austriaccording to the German Homeopathic Pharmacopeia.18,19

riefly, Q-potencies are prepared by rubbing substances useds remedies in a time-consuming process until a CH3 iseached equivalent to a 10−6 potentiation. Depending onts nature, the original substance is triturated in lactosemilk sugar) or its components were extracted in ethanol.he first stage is followed by step-wise dilution and succes-ion, changing every time from a solid medium (lactose) toiquid medium (ethanol-dilution) and back.18

Group 3-data were included for survival analysis, if theollowing criteria were met (Fig. 1): (1) Fatal tumor prog-osis and a sample size of at least 5 patients, met byiagnosis of glioblastoma grade IV (GBM), non-small-cellung cancer stage III and IV (NSCLC), small-cell lung cancerSCLC), pancreatic cancer (PC), inoperable cholangiocel-ular cancer (CCC), metastasized sarcoma (MSARC), andetastasized renal cell carcinoma (MRCC); (2) At least

hree visits to the Outpatient Unit between March 2004nd October 2009 (GBM and MRCC), March 2010 (LC, PC,CC), or August 2010 (MSARC); (3) Availability of patientescriptors including mean age, sex distribution, meannd median survival times, and one-to-three-year sur-ival times; and (4) Recording of relevant outcome datancluding stage of disease, disease prognosis, and time ofeath.

or GBM, 12—14 months20; for MRCC, 18—35 months21—23;or CCC, 10 months24; for PC, 8 and 22 months (locore-ional disease)25; for MSARC, 12 months26,27; for SCLC,—10 months (extended disease) and 14 months (limited

322 K. Gaertner et al.

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treatmen ts (n = 538 )

Records excluded (n = 251)

Records sc reened for cancer type

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records excluded with good-survival-prognosis

cancer types (n = 220)

Pa�en ts inc luded (n =54)

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Record s ex cluded due to incomplete data or

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Figure 1 Flow of information throug

isease)28; and for NSCLC 8—10 months (grade IV) and 15onths (grade III).29

esults

atient characteristics

uring the first four years, 538 patients presented at thetudy center for homeopathic treatment related to diag-osed cancer (group 1; 62.8% women) all of them receivingomeopathic treatment at least once. Numbers of patientsnd their proportioning can be seen in Table 1. Meange of total patients was 57 years (29—77 years). 53.7%n = 287; group 2) of patients had at least three homeo-athic consultations. Mean of appointment frequency was.6 in all patients and 8.2 in those with three or more

isits. In group 2, time from diagnosis to homeopathicreatment was 17.4 months on average, which includesatients who were diagnosed up to three years before thetart of the outpatient clinic. There was a wide range of

msts

e different phases of data collection.

ancer entities among the patients, with a similar distri-ution in both groups (1 + 2). In particular, 32.8% (n = 82)reast cancer patients, 13% (n = 37) with gastrointestinalumor and 15% (n = 43) hematological neoplasms, respec-ively. Any other type of cancer, notably lung cancer (n = 18),rain cancer (n = 16), PC (n = 10), CCC (n = 8), sarcoman = 17), MRCC (n = 8), thyroid cancer (n = 3), prostate can-er (n = 2), melanoma (n = 1), and other (n = 5) was foundn less than 10% of group 2-patients. 6 subgroups of malig-ancies with fatal prognosis and overall 10% of the patientsn = 54; group 3) fulfilled all criteria for survival analysisFig. 1).

All group 3-patients received conventional treatmentmmediately after diagnosis. Across the tumor-specificubgroups, average time from diagnosis to homeopathicreatment was 18—19 months. Up to 12 patient records22.2%) reported patient intolerance of conventional treat-

ent. The characteristics of patients and interventions are

hown in Tables 2 and 3. Fourteen patients lived longer thanhe observation period, and these cases were censured forurvival analysis (Fig. 2).

Additive homeopathic care in cancer patients 323

Table 1 Patients at the outpatient unit ‘‘homeopathy in malignant diseases’’, Internal Medicine I, Medical University Vienna.

Patients Number ofcases (n =)

Percentage oftotal cases (%)

Cases with morethan 3 homeopathicsessions (n =)

Cases with morethan 3 homeopathicsessions %

Includedcases (n =)

Includedcases %

Total 538 100 287 53.3 54 100Female 338 62.8 186 64.8 23 42.6Male 200 37.2 101 35.1 31 57.4Breast cancer 107 19.9 82 28.4 — —Haematologic

neosplasms52 9.7 38 13.1 — —

Small-cell-lungcancer + non-small-cell-lungcancer

31 5.8 20 6.9 10 18.5

Gastronintestinalneoplasms

36 6.7 24 8.3 — —

Glioblastomagrade IV

26 4.8 17 5.9 7 13

Metastasizedsarcoma

24 4.5 18 6.2 16 29.6

Pancreatic cancer 13 2.4 8 2.8 8 14.8Metastasized

renal cellcarcinoma

12 2.2 8 2.8 8 14.8

Cholangiocellularcarcinoma

7 1.3 5 1.7 5 9.3

Gynecologicalneoplasms

12 2.2 10 3.5 — —

Others 34 6.3 23 8 — —Not reported 182 33.8 34 11.8 — —

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Survival scores

Overall analysis showed that cancer patients with fatalprognosis and at least three treatment interventions withindividualized homeopathy in addition to conventional anti-cancer treatment had longer survival times compared tothose expected by oncologic experts and to those reportedin the literature. More than half of the patients (65%)matched or exceeded the survival times reported in the lit-erature for only 20% of patients of their cancer type.24—33

Median overall survival was prolonged in all observed cancerentities (Table 4). The significance of these latter find-ings was determined using Wilcoxon tests which examinednumbers of patients who exceeded the median survivaltime reported in the literature for a particular cancer andnumbers who did not. Results of these analyses yieldedsignificant findings for all groups collapsed over cancertypes (p < 0.001), as well as for the CCC (p = 0.043), GBM(p = 0.043), and MSARC (p < 0.001) groups. In contrast, find-ings were not significant for the PC, MRCC, NSCLC, andSCLC groups (p’s > 0.05). Three-year survival was higher inall tumor entities than suggested in the literature (1.5—55

months), except NSCLC.19—28 Longer survival correlated pos-itively with frequency of homeopathic treatment (Pearsonr = 0.425, p < 0.001), although this relationship was not con-sistent throughout all groups.

ctba

iscussion

ompared to the literature, the study findings indicateonger survival for patients with additive homeopathy duringancer treatment than those with conventional treatmentlone. Although results are promising and suggest the needor additional work, several important study limitations areoted. The sample of patients is small and drawn only fromne clinic. It is not possible to assume that the potentialffects of homeopathic treatment are more or less helpfulor specific cancer entities. However, an advantage of thisata collection was to provide an overview of seven differentancer types, and findings show a continuously positive cor-elation between the number of homeopathic consultationnd reached survival time. Furthermore external validity isigh.30

As this was a retrospective analysis, findings may note replicated using a prospective methodology. Conser-ative treatment was not consistent within the groups,nd there was no randomization. Characteristics, per-eptions, hopes, and ideas of cancer patients choosingomeopathic care likely contributed to the present out-

ome though were not reported. Previous data suggest thathese patients in the present study are slightly youngerut with a poorer state of health than those patients whore provided with only conventional treatment.31 Measured

324

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aertner et

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Table 2 Treatment of analyzed patients; abbreviations: sbl, secondary blastomatous lesions; bmt, bone marrow transplantation; IFN, interferon; IFADIC, soft-tissue sarcomaprotocol with administration of Ifosfamid, Doxorubicin and Darcarbacin.

Tumor type Glioblastoma grade IV(n = 7)

Metastasizedrenal cellcarcinoma(n = 8)

Metastasizedsarcoma (n = 12)

Cholangiocaellularcarcinoma

Pancreaticcarcinoma

Non-small-cell-lung-carcinoma

Small-cell-lung-carcinoma

Stadium I—III 0 Low risk (n = 6) 9 0 3 3 Limited (n = 2)Stadium IV 7 Intermediate

risk (n = 2)4 5 4 4 Extended (n = 1)

Metastasis/relaps 0 8 15 1 5 4 2Surgery 7 8 14 2 3 2 2Total resection 3 7 11 0 0 0 0Partial resection 2 0 3 2 2 2 0Resection of sbl 0 6 14 0 1 0 2Chemotherapy 7 8 12 5 8 7 3First-line Temodozoline (n =

3)/Dacarbacine +Fotemustine (n = 4)

Cisplatin (n =1)/Navelbine (n= 2)/IFN (n =4)/Gemzar (n =1)

Epirubicin +Ifosfamid (n =5)/Doxorubicin (n =2)/Gemcitabine (n =1)/IFADIC (n =1)/Cisplatin (n =1)/IFN (n =1)/Sorafenib (n = 1)

Gemcitabine +Oxalilatin (n = 5)

Gemcitabine +Oxalilatin (n = 1)/Gemcitabine(n = 5)

Cisplatin +Gemcitabine (n =3)/+Vinorelbine (n= 1)/+Navelbine (n= 2)/Carboplatin +Taxotere (n = 1)

Cisplatin +Etoposid (n = 3)

Second-line Temodozolin(n = 1)/Endotecarin(n = 1)/Gefintinib (n = 1)

Capecitabine(n = 3)/Sorafenib(n = 2)/Gemzar(n = 1)/IFN(n = 1)

Taxotere(n = 6)/Doxorubicin(n = 2)/Gemzar(n = 1)/Epirubicin +Ifosfamid(n = 1)/Permetrexed(n = 1)

Capecitabine(n = 1)/+Irinotecan(n = 1)

Capecitabine(n = 2)/+Oxaliplatin(n = 1)/Irinotecan(n = 1)

Docetaxel(n = 1)/Taxotere+Erlotinib(n = 1)/Navelbine(n = 1)/Gemcitabine(n = 1)/Erlotinib(n = 2)

Cisplatin/Irinotecan (n = 1)

Third-line andmore

Imatinib (n = 1)/Hydroxycarbamide(n = 1)

Erlotinib(n = 3)/Vinorelbine(n = 1)

Carboplatin(n = 1)/Taxotere(n = 2)/Yondelis(n = 2)/Dacarbacin(n = 1)/Etoposid(n = 1)/Doxorubicin(n = 1)/Sorafenib(n = 1)/Ifosfamid(n = 2)

Bevacizumab(n = 1)

Gemcitabine +Oxalilatin(n = 1)/Irinotecan(n = 1)/Capecitabine(n = 1)/Raltitrexed(n = 1)/Erlotinib(n = 1)

Taxotere(n = 1)/+Pemetrexed(n = 1)

Topotecan (n = 1)

Radiotherapy 7 4 11 0 1 7 3Primary 7 0 10 0 0 7 0Palliative (sbl) 2 4 4 0 1 4 3Other therapies 1 4 2 1 1 3 0

Additive hom

eopathic care

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patients

325

Targetedtherapies

Imatinib(n = 1)/Gefitinib (n = 1)

Bevacizumab(n = 2)/Erlotinib(n = 3)/Sorafenib(n = 2)

Sorafenib (n = 2) Bevacizumab(n = 1)

Erlotinib (n = 1) Erlotinib (n = 3) 0

Immune systemmodulation

0 bmt (n = 1) 0 0 0 0 0

Homeopathictreatment

7 8 15 5 8 7 3

Duringconventionaltreatment

4 6 13 5 4 7 2

Afterconventionaltreatment

3 2 2 0 4 0 1

Most commonremedies

Nux vomica, sulphur,thuja, phosphorus

Natriummuriaticum,nux omica,phosphorus

Arnica montana,lachesis, sulphur

Phosphorus,sulphur,lycopodium

Arsenicum album Phosphorus Natriummuriaticum

326

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Table 3 Patients at the outpatient unit ‘‘homeopathy in malignant diseases’’, Internal Medicine I, Medical University Vienna; abbreviations: GBM, glioblastoma; MRCC, metas-tasized renal cell carcinoma; MSARC, metastasized sarcoma; ccc, cholangiocallular carcinoma; pc, pancreatic carcinoma; NSCLC, non-small-cell lung carcinoma; SCLC, small-celllung carcinoma, sbl, secondary blastomatous lesions; S, one surgery performed; C, first-line chemotherapy; R, one session radiotherapy; BMT, bone mark transplantation; 1

numbers before placeholders (S, C, R) indicate the numbers of cycles, i.e. operations, chemotherapy cycles, radiotherapy cycles; 2 in relation to conventional treatment; 3

according to experts assessments and literature-data.

ID Tumor type Specification(localization of primaryaffection and sbl)

Age Sex Conventionaltreatment

Time fromdiagnosis tohomeopathictreatment (month)

Time ofhomeopathictreatment2

Number ofhomeopathicsessions

Expectedsurvival3

(month)

Reachedsurvival(month)

1 GBM Grade IV occipital 77 m S-C-2R 4 During 3 13 92 GBM Grade IV

temporo-occipital52 f S-2C-R 10 After 4 13 16

3 GBM Grade IVtemporo-parietal

62 m S-2C-R 10 After 3 13 18

4 GBM Grade IV temporal 43 f S-C-R 4 During 3 13 195 GBM Grade IV temporal 65 m S-C-R 3 After 5 13 236 GBM Grade IV temporal 49 f 2C-2R 0 During 6 13 417 GBM Grade IV multifocal 54 m 3C-R 1 During 27 13 578 MRCC sbl eye, low risk 53 m S-2C-2R 1 During 3 35 79 MRCC sbl uterus + ovar low

risk54 f 3S-C-2R 15 During 6 35 32

10 MRCC sbl lungs, bones,intermediate risk

58 m 4S-3C 0 During 5 35 39

11 MRCC sbl brain, bones, lowrisk

66 m 5S-6C 35 During 5 35 54

12 MRCC sbl abdomen + pulmo,low risk

47 m 2S-7C 49 During 4 35 69

13 MRCC sbl bones + pulmo, lowrisk

59 m 2S-2C 32 After 14 35 98

14 MRCC sbl pulmo, low risk 62 m S-2C 54 After 13 35 11415 MRCC sbl brain, bones, pulmo

intermediate risk63 m 2S-C + BMT 103 During 11 35 115

16 MSARC Vertebral spindle cellliposarcoma

74 f 2S-R 7 During 5 12 51

17 MSARC Leiomyosarcoma knee 45 m 3S-C 11 After 7 12 3418 MSARC Scrotal

leiomyosarcoma62 m 5S-2R 87 During 4 12 73

19 MSARC Clear cell sarcoma leftfoot

35 f 4S-C-2R 97 During 3 12 52

20 MSARC Myxofibrosarcomaretroperitoneal

64 m S-C-R 9 During 3 12 21

21 MSARC Liposarcoma 46 f 10S 81 During 22 12 144

Additive hom

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327

22 MSARC Epitheloidmesotheliomamultifocal

61 m 3C-R 11 During 4 12 25

23 MSARC Myxoidchondrosarcomaextra-scelettal

30 f 2S-4C-R 2 During 3 12 57

24 MSARC Giant cell synovialsarcoma, lateral chest

29 m 4S-4C-3R 41 During 9 12 31

25 MSARC LeiomyosarcomaUterus high grade GIST

50 f 3S-7C-R 32 During 4 12 43

26 MSARC Rhabdomyosarcoma,prostate

35 m 3S-3C-R 0 During 10 12 24

27 MSARC Myxoidleiomyosarcoma, femur

47 f 2S-2C-3R 53 After 18 12 55

28 MSARC Spindle cell synovialsarcom, right foot

55 m 6S-3C 72 During 6 12 119

29 MSARC Synovial sarcoma,peritracheal andparalaryngeal right

46 m 2S-2C-2R 1 In between 7 12 8

30 MSARC Leiomyosarcomaovaries

48 f S-5C No data During 11 12 99

31 MSARC Retroperitonealleiomyosarcoma

34 m 2S-4C 1 During 6 12 26

32 CCC Intrahepatal 46 f C 0 During 19 10 3933 CCC Intrahepatal 55 m S2-CR 3 During 3 10 3634 CCC No data 33 f C 2 During 4 10 1635 CCC Metastasized 65 m S-3C 41 In between 4 10 7536 CCC Metastasized 59 f C 8 During 3 10 2837 PC Stadium III 60 f S-3C 4 After 4 22 1538 PC Stadium IV,

metastasized71 f S-C 9 After 8 8 25

39 PC Stadium IV,metastasized

77 f 2-C 10 During 3 8 19

40 PC Stadium I 59 m S-4C 24 After 3 22 2641 PC Stadium IV,

metastasized77 f None 1 During 5 8 1

42 PC Stadium IV,metastasized

63 m Radionucleidembolization

? After 16 8 36

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Table 3 (Continued)

ID Tumor type Specification(localization of primaryaffection and sbl)

Age Sex Conventionaltreatment

Time fromdiagnosis tohomeopathictreatment (month)

Time ofhomeopathictreatment2

Number ofhomeopathicsessions

Expectedsurvival3

(month)

Reachedsurvival(month)

43 PC Stadium IV,metastasized

59 f C 6 During 3 8 14

44 PC Stadium II, inoperabel 62 m 5C-R 2 During 3 22 2045 NSCLC Stadium IIIa, right

lower lamb54 f S-C-R 5 During 17 15 41

46 NSCLC Stadium IV,metastasized

55 m 2-C 1 During 10 10 22

47 NSCLC Stadium IIIA 55 m 3C-R 1 During 11 15 5048 NSCLC Stadium IV,

metastasized54 f C-R 2 During 5 10 10

49 NSCLC Stadium IIIB 63 m 3C-R 0 During 15 15 1550 NSCLC Stadium IV,

metastasized67 m S-2C-R 6 During 4 10 13

51 NSCLC Stadium IV,metastasized

57 f 3C-R 3 During 3 10 8

52 SCLC Extended disease 42 m S-2C-R 2 During 3 10 4753 SCLC Limited disease 57 m S-C-R 12 After 19 16 7754 SCLC Extended disease 54 f C-R 7 During 4 10 15

Additive hom

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329

Table 4 Survival time of the analyzed sample compared to data from literature 1according to literature-data; 2reached vs. individually estimated survival times according toexperts’ assessments.

Tumor type Expected1-yearsurvival %1

Reached1-yearsurvival %

Expected2-yearsurvival %1

Reached2-yearsurvival %

Expected3-yearsurvival %1

Reached3-yearsurvival %

Expected mediansurvival1

(months)

Reachedmedian survival(months)

p-Valuecorresponding toWilcoxon-test forsurvival data inmonths2

Glioblastoma grade IV(n = 7)

60 85.7 27.2 28.5 16 28.6 14.6 19 0.043

Metastasized renalcell carcinoma(n = 8)

79—85.4 87.5 54 87.5 43—76.6 75 26.4 61.4 0.069

Small-cell-lung cancer(n = 3)

<50 100 No data 66.7 <9 66.7 9.8—13.5 47 0.109

Non-small-cell lungcancer (n = 7)

34.3 71.4 14.7 28.7 9 28.7 11.3 15 0.08

Pancreatic carcinoma(n = 8)

8 87.5 5.8 37.5 No data 12.5 6.6 17.5 0.262

Cholangiocellularcarcinoma (n = 5)

48.8 100 20—25 80 19.4 60 15.6 36 0.043

Metastasized sarcoma(n = 16)

50 93.8 38.7 87.5 No data 56.3 18 47 0.001

Overall — — — — — — — — <0.001

330 K. Gaertner et al.

Figure 2 Comparison of median survival times (abbreviations: gbm: glioblastoma grade IV; mrcc: metastasized renal cell carci-noma; SCLC: small-cell-lung cancer; NSCLC: non-small-cell lung cancer; PC: pancreatic carcinoma; ccc: cholangiocellular carcinoma;msarc: metastasized sarcoma).

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lobal health status and measured subjective well-being ofancer patients appear to improve significantly with home-pathic treatment.13 It is known that well-being can be anndicator for longer patient survival,32—34 this might be aontributing factor to our findings. Measurement of well-eing would enhance future work. Active participation inreatment, such as choosing treatment options, seems to benother predictor of longer survival of cancer patients.35

omeopathy, however, is thought to act on the wholerganism,36,37 i.e. evenly on the nervous, the hormonal, andellular systems.38,39 Taken in whole, these data suggest aAM mediated or modulated positive neuro-immunologicalrocesses40 that may affect the growth and propagation ofancer.41—43

In summary, the prolonged survival times of patients inhe present study are encouraging and show the need forurther study of homeopathic care in cancer patients. Such

ork could include a randomized controlled trial on qualityf life and survival of patients who use additive homeopathyn their cancer therapy as compared to conventional therapylone.

R

onflict of interest

he authors have no conflict of interest to declare.

cknowledgements

ratitude for the contribution to this project is given to: Dr.. Kaiblinger, Dr. H. Lasslesberger, Dr. N. Szymanski, B.Sc.. Gaertner and collaboration from the Medical University ofienna, especially to Dr. Th. Brodowicz, Dr. Kornek, Dr. U.ogl, Dr. M. Pirker, and Dr. Chr. Zielinski. Significant appreci-tion is noted for Dr. Patricia B. Sutker, Ph.D., and Albert N.llain, M.S., for their assistance in the final version of thisanuscript.

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