Patients with Advanced Pancreatic Cancer Treated with Mistletoe and Hyperthermia in Addition to Palliative Chemotherapy: A Retrospective Single-Center Analysis

SIMPLE SUMMARY: Pancreatic cancer is associated with poor survival, despite advances in anti-cancer treatment. Most patients are diagnosed at an advanced stage, so the treatment goal is prolongation of survival and maintenance of quality of life instead of cure. In this context, integrative therapeutic approaches have become increasingly important in recent years. Integrative therapies are usually not used alone but complementary to conventional treatment to optimize its effect. Positive effects have been described for symptom alleviation, e.g., pain and quality of life improvement by the additional use of integrative therapies. However, the available data are not sufficient for a conclusive assessment regarding a possible influence on survival. The present work sought to describe the outcome of patients with advanced or metastatic pancreatic cancer not amenable to curative treatment, who received either conventional therapy or additional complementary integrative mistletoe and/or hyperthermia. ABSTRACT: This retrospective analysis investigated the influence of integrative therapies in addition to palliative chemotherapy in patients with advanced pancreatic cancer, treated at a single institution specialized in integrative oncology between January 2015 and December 2019. In total, 206 consecutive patients were included in the study, whereof 142 patients (68.9%) received palliative chemotherapy (gemcitabine/nab-paclitaxel 33.8%; FOLFIRINOX 35.9%; gemcitabine 30.3%) while the remainder were treated with best supportive and integrative care. Integrative therapies were used in 117 of 142 patients (82.4%) in addition to conventional chemotherapy, whereby mistletoe was used in 117 patients (82.4%) and hyperthermia in 74 patients (52.1%). A total of 107/142 patients (86.3%) died during the observation period, whereby survival times differed significantly depending on the additional use of integrative mistletoe or hyperthermia: chemotherapy alone 8.6 months (95% CI 4.7–15.4), chemotherapy and only mistletoe therapy 11.2 months (95% CI 7.1–14.2), or a combination of chemotherapy with mistletoe and hyperthermia 18.9 months (95% CI 15.2–24.5). While the survival times observed for patients with advanced pancreatic cancer receiving chemotherapy alone are consistent with pivotal phase-III studies and German registry data, we found significantly improved survival using additional mistletoe and/or hyperthermia.