Matthias Rostock

Internal Medicine (General Medicine), Oncology

26.44

Publications

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    ABSTRACT: Objectives Extracts of the tubers of Harpagophytum procumbens (devil's claw, DC) inhibit different proinflammatory mediators important in the pathophysiology of osteoarthritis. Many plant-derived preparations interfere with cytochrome P450 liver enzymes, which influence their different biological activities. Therefore, the present study was designed to investigate the influence of an external metabolic activation of a DC extract on the cytotoxicity and the release of proinflammatory cytokines. MethodsA screening experiment with a panel of 12 inflammatory cytokines identified three as suitable for the study: tumour necrosis factor- (TNF-), interleukin (IL) IL-6 and IL-8. They were determined using enzyme-linked immunosorbent assays in lipopolysaccharide (LPS)-stimulated monocytic THP-1 cells, which were treated with rat liver S9 mix metabolically activated DC extract (DCm). For the cytotoxity experiments, a WST-1 assay was used. Key findingsDC dose-dependently suppressed the release of TNF-, IL-6 and IL-8 in LPS-stimulated monocytic THP-1 cells at non-cytotoxic concentrations (50-250g/ml). The metabolic activation of the DC extract by S9 mix did not alternate its cytotoxicity and did not diminish its inhibitory effect. This effect was improved in the case of TNF- inhibition as reflected by their EC50 values of 1168.2g/ml and 49 +/- 3.5g/ml for DC and DCm (P<0.01). Conclusions Cytokines inhibitory activity of DC was not affected after its external metabolic activation. However, the amount of harpagoside and caffeic acid derivates was decreased. Other components of the extract might have contributed to its anti-inflammatory effect.
    09/2014; 66(11). DOI:10.1111/jphp.12242
  • Forschende Komplementärmedizin / Research in Complementary Medicine 01/2014; 21 Suppl 1(s1):2-18. DOI:10.1159/000362393 · 1.65 Impact Factor
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    ABSTRACT: Oral mucositis is one of the common side effects of chemotherapy treatment with potentially severe implications. Despite several treatment approaches by conventional and complementary western medicine, the therapeutic outcome is often not satisfactory. Traditional Chinese Medicine (TCM) offers empirical herbal formulas for the treatment of oral ulceration which are used in adaptation to chemotherapy-induced mucositis. While standard concepts for TCM treatment do not exist and acceptance by conventional oncologists is still low, we conducted a review to examine the evidence of Chinese herbal treatment in oral mucositis. Eighteen relevant studies on 4 single herbs, 2 combinations of 2 herbs, and 11 multiherbal prescriptions involving 3 or more compounds were included. Corresponding molecular mechanisms were investigated. The knowledge about detailed herbal mechanisms, especially in multi-herbal prescriptions is still limited. The quality of clinical trials needs further improvement. Meta-analysis on the existent database is not possible but molecular findings on Chinese medicinal herbs indicate that further research is still promising for the treatment of chemotherapy-induced oral mucositis.
    Evidence-based Complementary and Alternative Medicine 10/2013; 2013:284959. DOI:10.1155/2013/284959 · 1.88 Impact Factor
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    ABSTRACT: Purpose. Chemotherapy-induced peripheral neuropathy (CIPN) is a common and dose-limiting side effect of cytostatic drugs. Since there are no proven therapeutic procedures against CIPN, we were interested to define the role of electroacupuncture (EA) from which preliminary data showed promising results. Methods. In a randomized trial with a group sequential adaptive design in patients with CIPN, we compared EA (LV3, SP9, GB41, GB34, LI4, LI11, SI3, and HT3; n = 14) with hydroelectric baths (HB, n = 14), vitamin B1/B6 capsules (300/300 mg daily; VitB, n = 15), and placebo capsules (n = 17). The statistical power in this trial was primarily calculated for proving EA only, so results of HB and VitB are pilot data. Results. CIPN complaints improved by 0.8 ± 1.2 (EA), 1.7 ± 1.7 (HB), 1.6 ± 2.0 (VitB), and 1.3 ± 1.3 points (placebo) on a 10-point numeric rating scale without significant difference between treatment groups or placebo. In addition no significant differences in sensory nerve conduction studies or quality of life (EORTC QLQ-C30) were found. Conclusions. The used EA concept, HB, and VitB were not superior to placebo. Since, contrary to our results, studies with different acupuncture concepts showed a positive effect on CIPN, the effect of acupuncture on CIPN remains unclear. Further randomized, placebo controlled studies seem necessary. This trial is registered with DRKS00004448.
    Evidence-based Complementary and Alternative Medicine 08/2013; 2013:349653. DOI:10.1155/2013/349653 · 1.88 Impact Factor
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    ABSTRACT: Chemotherapy-induced neuropathy (CIPN) has a relevant impact on the quality of life of cancer patients. There are no curative conventional treatments, so further options have to be investigated. We conducted a systematic review in English and Chinese language databases to illuminate the role of medical herbs. 26 relevant studies on 5 single herbs, one extract, one receptor-agonist, and 8 combinations of herbs were identified focusing on the single herbs Acorus calamus rhizoma, Cannabis sativa fructus, Chamomilla matricaria, Ginkgo biloba, Salvia officinalis, Sweet bee venom, Fritillaria cirrhosae bulbus, and the herbal combinations Bu Yang Huan Wu, modified Bu Yang Huan Wu plus Liuwei Di Huang, modified Chai Hu Long Gu Mu Li Wan, Geranii herba plus Aconiti lateralis praeparata radix , Niu Che Sen Qi Wan (Goshajinkigan), Gui Zhi Jia Shu Fu Tang (Keishikajutsubuto), Huang Qi Wu Wu Tang (Ogikeishigomotsuto), and Shao Yao Gan Cao Tang (Shakuyakukanzoto). The knowledge of mechanism of action is still limited, the quality of clinical trials needs further improvement, and studies have not yielded enough evidence to establish a standard practice, but a lot of promising substances have been identified. While CIPN has multiple mechanisms of neuronal degeneration, a combination of herbs or substances might deal with multiple targets for the aim of neuroprotection or neuroregeneration in CIPN.
    Evidence-based Complementary and Alternative Medicine 07/2013; 2013:423713. DOI:10.1155/2013/423713 · 1.88 Impact Factor
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    Markus Horneber · Matthias Rostock
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    ABSTRACT: Die Fortschritte der modernen Onkologie mit ihren vielfältigen und komplexen Möglichkeiten der Diagnose und Therapie von Krebserkrankungen haben dazu geführt, dass mehr Patientinnen und Patienten geheilt werden. Dafür müssen viele Betroffene allerdings eine beeinträchtigende Therapiephase bewältigen und erleben für die Dauer ihres geretteten Lebens bleibende Krankheitsauswirkungen und Rezidivängste. Auch die Fortschritte der palliativen Onkologie, die mehr Krebskranken ein längeres Leben mit der Erkrankung ermöglichen, fordern eine längere Adaptationsleistung an das Leben mit einer lebensbedrohlichen chronischen Krankheit und oft nebenwirkungsträchtigen Langzeittherapien. In dieser prozesshaften und mehrdimensionalen Auseinandersetzung mit Krankheit und Kranksein spielt für viele Patientinnen und Patienten und ihr soziales Umfeld der Umgang mit der sog. Komplementärmedizin eine wichtige Rolle. Dieser Beitrag gibt einen Überblick über die wichtigsten Verfahren.
    best practice onkologie 04/2013; 5(4):44-54. DOI:10.1007/s11654-010-0250-0
  • R Saller · M Rostock
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    ABSTRACT: The active components of herbal drugs and substances are pleiotropic multi-ingredient compounds with multitarget properties including antiinflammatory effects. A pleiotropic inhibition of inflammation could play an important role in mutlimorbide patients as an attempt of prevention or retardation of metastasis. A large number of experimental data for European and non-European herbal drugs as well as various herbal drug combinations suggest such a possibility. Despite the so far small number of clinical studies, such an experimental herbal treatment could appear to be reasonable and acceptable, provided that there are data available on quality and safety of these herbal drugs by treatments of patients with various diseases. Besides, herbal drugs and substances play a growing role the treatment of patients with multimorbidity. Many of these herbal drugs have antiinflammatory effects beside their proved symptomatic efficacy in a lot of other diseases. The specific selection of herbal drugs that are efficacious in specific indications and additionally showed antiinflammatory effects offers the possibility of simultaneous antiinflammatory and specific efficacy. St. John's Wort and milk thistle belong to the oldest and to the best experimentally and clinically examined herbal remedies. The spectrum of internal and external uses of Hypercum perforatum as a multicompound herbal drug includes functional gastro-intestinal complaint and illness, skin disease, mucosal lesion, superficial injury, depressive upset and depression, somatoform disorders, restlessness, nervosity, convalescence, exhaustion and sleep disturbances respectively. The plurivalent character of the multicompound even enables a broad spectrum of activity. This might justify to prefer St. John's Wort to other drugs in a wide range of treatments: In multimorbide patients with depression or in depressive patients with coronary heart disease the anti-inflammatory effects could mean an additional advantage. However, at present there is still a great need and demand for therapy-oriented clinical research.
    Praxis 12/2012; 101(25):1637-42. DOI:10.1024/1661-8157/a001149
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    ABSTRACT: Background Drugs of plant origin such as Arnica montana, Calendula officinalis or Hypericum perforatum have been frequently used to promote wound healing. While their effect on wound healing using preparations at pharmacological concentrations was supported by several in vitro and clinical studies, investigations of herbal homeopathic remedies on wound healing process are rare. The objective of this study was to investigate the effect of a commercial low potency homeopathic remedy Similasan® Arnica plus Spray on wound closure in a controlled, blind trial in vitro. Methods We investigated the effect of an ethanolic preparation composed of equal parts of Arnica montana 4x, Calendula officinalis 4x, Hypericum perforatum 4x and Symphytum officinale 6x (0712–2), its succussed hydroalcoholic solvent (0712–1) and unsuccussed solvent (0712–3) on NIH 3T3 fibroblasts. Cell viability was determined by WST-1 assay, cell growth using BrdU uptake, cell migration by chemotaxis assay and wound closure by CytoSelect ™Wound Healing Assay Kit which generated a defined “wound field”. All assays were performed in three independent controlled experiments. Results None of the three substances affected cell viability and none showed a stimulating effect on cell proliferation. Preparation (0712–2) exerted a stimulating effect on fibroblast migration (31.9%) vs 14.7% with succussed solvent (0712–1) at 1:100 dilutions (p < 0.001). Unsuccussed solvent (0712–3) had no influence on cell migration (6.3%; p > 0.05). Preparation (0712–2) at a dilution of 1:100 promoted in vitro wound closure by 59.5% and differed significantly (p < 0.001) from succussed solvent (0712–1), which caused 22.1% wound closure. Conclusion Results of this study showed that the low potency homeopathic remedy (0712–2) exerted in vitro wound closure potential in NIH 3T3 fibroblasts. This effect resulted from stimulation of fibroblasts motility rather than of their mitosis.
    BMC Complementary and Alternative Medicine 07/2012; 12(1):100. DOI:10.1186/1472-6882-12-100 · 1.88 Impact Factor
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    Schweizerische Zeitschrift fur GanzheitsMedizin 01/2012; 24(2):95-100. DOI:10.1159/000337474
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    Markus Horneber · Anja Mehnert · Traugott Roser · Matthias Rostock
    Onkologie 01/2012; 35 Suppl 3:2-5. · 0.84 Impact Factor
  • Markus Horneber · Friedrich Overkamp · Matthias Rostock
    Onkologie 01/2012; 35 Suppl 5(s5):3-11. DOI:10.1159/000340025 · 0.84 Impact Factor
  • Markus Horneber · Anja Mehnert · Traugott Roser · Matthias Rostock
    Onkologie 01/2012; 35(s3):2-5. DOI:10.1159/000338974 · 0.84 Impact Factor
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    ABSTRACT: Background: In outpatient settings diagnostic classification of depressive symptoms is mostly descriptive based on ICD-10. Depending on clinical experience and consultation time, diagnosis can be verified by validated scales. However, physicians working in primary care are familiar with ICD-10 criteria. Therefore, the aim of the present study was to examine the feasibility of the validation of an ICD-10-derived symptom scale for depression. Methods: For this preliminary trial we generated a symptom scale derived 1:1 from the diagnostic criteria for depression given in the ICD-10 with 10 items. The Hamilton Rating Scale for Depression (HAMD-17) was used as reference in a population of 226 outpatients suffering from depressive symptoms. Correlation between scales as well as sensitivity and specificity of the ICD-10 scale were calculated. Results: The generated ICD-10 symptom scale for depression could be analyzed in 219 patients and showed a significant and strong correlation with the HAMD-17 (p < 0.0001; ρ = 0.75). The best tradeoffs between specificity and sensitivity of the ICD-10 score were found at 10 points for the lower and 14 points for the upper cut-off. Overall sensitivity and specificity was 76.7 and 88.6%. Almost two thirds (i.e. 65.3%) of the patients were correctly classified by the ICD-10 scale. Conclusion: The ICD-10 symptom scale examined in the current population was found to have fair correlation with the HAMD-17 as well as, in face of the limited variance of the patients' condition, acceptable sensitivity and specificity. Therefore, this preliminary study showed that the ICD-10-derived symptom scale seems appropriate to be investigated in a thorough validation trial.
    Forschende Komplementärmedizin / Research in Complementary Medicine 01/2012; 19(4):191-6. DOI:10.1159/000342018 · 1.65 Impact Factor
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    ABSTRACT: Treatment of rheumatic or musculoskeletal disorders (MD) is multi-disciplinary and includes herbal analgesics. Although already reviewed, no quantitative evaluation of efficacy and safety of the herbal combination Phytodolor® (STW1) is available. We searched in databases and contacted authors and the manufacturer to identify randomized controlled trials (RCTs) examining STW1 in patients with MD. We made a reanalysis of raw data of eligible published and unpublished RCTs and pooled the results for meta-analysis according to Cochrane guidelines and intention-to-treat. Primary outcome measure was patient global assessment of efficacy, secondary outcome measure was pain at rest and on movement. Results were stratified according to treatment groups. Patient data of 11 RCTs were eligible for pooling. In the entire population, STW1 was significantly superior compared to placebo in patients' global assessment of efficacy (group difference for rating very good/good: 20%; placebo 48.9% and STW1 69.1%; p < 0.001; OR 0.43; 95% CI 0.28-0.65) and in the subpopulation 'other rheumatic diseases' (placebo 45.4%; STW1 72.3%; p < 0.001; OR 0.32; 95% CI 0.2-0.52), but not in the subpopulation 'gonarthrosis'. STW1 did not differ significantly compared to non-steroidal anti-inflammatory drugs (NSAIDs), neither in the entire population nor the subpopulations. Similar results were found for pain at rest and on movement. No serious adverse events (AE) but minor AE were reported (placebo 8.1%; STW1 14.2%; NSAIDs 18.9%). According to the analysed data, STW1 showed a better pain reduction than placebo in patients with pain due to MD, probably equivalent to NSAIDs, and was well tolerated.
    Forschende Komplementärmedizin / Research in Complementary Medicine 10/2011; 18(5):249-56. DOI:10.1159/000332820 · 1.65 Impact Factor
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    ABSTRACT: Purpose: Several questionnaire-based clinical studies have shown that mistletoe therapy (MT) as part of a multi-modal therapeutic approach may improve patients’ quality-of-life (QoL). The purpose of this study was to provide qualitative information on the nature of this improvement. Methods: This exploratory, prospective, cohort-study was authorized by the ethics committee of canton Zurich and included 25 patients with different types of cancer. The patients filled in the EORTC QLQ-C30 Version 3.0 QoL questionnaire at the beginning of MT (n = 25) and 3 months later (n = 21). If patients agreed, they were interviewed by the researchers on both occasions (n = 17); the interviews were transcribed verbatim and submitted to a qualitative content analysis (n = 12). Results: The results obtained with EORTC QLQ-C30 showed significant improvements of several questionnaire-subscales. Analysis of the interviews revealed that most patients adopted MT with a supportive goal, with all patients making use of conventional therapies. After 3 months of MT, most interviewed patients reported some improvements of their QoL, which were often related to a higher vitality and autonomy. MT was often seen as a chance to make an own personal contribution to the therapy. Concrete personal achievements such as changes in the private and/or professional environment were spontaneously mentioned by the patients, not only illustrating their improvements in QoL, but also reflecting a stronger vitality and a superior coping with the disease. Conclusions: Our observations suggest that MT, with its various components – mistletoe preparation, repeated (self-)injection, CAM-setting with intensive personal contact with health professionals – and as part of a multi-modal therapy seems to contribute to an improvement in QoL and a superior coping with cancer. Keywords: Cancer; Mistletoe; Quality of life; Qualitative research; Interviews; EORTC QLQ-C30
    Phytomedicine 10/2011; 18. DOI:10.1016/j.phymed.2011.09.037 · 2.88 Impact Factor
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    ABSTRACT: The antihormonal therapy of breast cancer patients with the antiestrogen tamoxifen often induces or aggravates menopausal complaints. As estrogen substitution is contraindicated, herbal alternatives, e.g. extracts of black cohosh are often used. A prospective observational study was carried out in 50 breast cancer patients with tamoxifen treatment. All patients had had surgery, most of them had undergone radiation therapy (87%) and approximately 50% had received chemotherapy. Every patient was treated with an isopropanolic extract of black cohosh (1-4 tablets, 2.5 mg) for 6 months. Patients recorded their complaints before therapy and after 1, 3, and 6 months of therapy using the menopause rating scale (MRS II). The reduction of the total MRS II score under black cohosh treatment from 17.6 to 13.6 was statistically significant. Hot flashes, sweating, sleep problems, and anxiety improved, whereas urogenital and musculoskeletal complaints did not change. In all, 22 patients reported adverse events, none of which were linked with the study medication; 90% reported the tolerability of the black cohosh extract as very good or good. Black cohosh extract seems to be a reasonable treatment approach in tamoxifen treated breast cancer patients with predominantly psychovegetative symptoms.
    Gynecological Endocrinology 10/2011; 27(10):844-8. DOI:10.3109/09513590.2010.538097 · 1.14 Impact Factor
  • M. Rostock · R. Saller
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    ABSTRACT: Viele Brustkrebspatientinnen leiden unter den Nebenwirkungen ihrer antihormonellen Therapie. Klimakterische Beschwerden in Form von Hitzewallungen, Nachtschweiß, Libidoverlust, Ängsten, Depressionen oder auch Muskel- und Gelenkschmerzen führen in vielen Fällen zu einer Verschlechterung der Therapieadhärenz. Die Effektivität einer Begleittherapie mit selektiven Serotonin-Wiederaufnahmehemmern (SSRI), Gabapentin oder Clonidin konnte in verschiedenen randomisierten klinischen Studien (RCT) belegt werden. Allerdings lehnen viele Patientinnen eine Behandlung mit diesen Medikamenten ab, u. a. weil sie zusätzliche Nebenwirkungen fürchten. Demgegenüber besteht eine große Nachfrage nach komplementären Therapiemöglichkeiten, aber erst in den letzten Jahren gibt es zunehmend mehr und auch qualitativ bessere klinische Studien zu ihrer wissenschaftlichen Erforschung. Drei RCT mit isolierten Soja-Isoflavonen zeigten keine Überlegenheit gegenüber Placebo. Drei von fünf klinischen Studien mit Extrakt aus der Traubensilberkerze ergaben eine Reduktion der Hitzewallungen, die vierte Studie wies keinen Effekt auf Hitzewallungen nach, jedoch auf die Intensität des Schwitzens; in der fünften war das Verum dem Placebo nicht überlegen. In einer Phase-II-Studie reduzierten sich unter Einnahme von Leinsamenschrot die Hitzewallungen, eine placebokontrollierte Folgestudie ergab jedoch keinen signifikanten Unterschied zur Kontrolle. Ebenso wurden in einer unkontrollierten Kohortenstudie unter homöopathischer Behandlung positive Effekte auf die klimakterischen Beschwerden der behandelten Patientinnen erreicht, während zwei nachfolgende RCT zu einem Nullergebnis führten. Demgegenüber ergab eine Metaanalyse für die Verum-Akupunktur eine signifikante Überlegenheit gegenüber Sham-Akupunktur. Auch mit einem komplexen Entspannungstraining mit Yoga, Meditation und Atemübungen ließen sich Hitzewallungen im Vergleich zur Kontrolle statistisch signifikant reduzieren. Zwei kleine unkontrollierte Pilotstudien zeigten nach Stellatumblockade einen deutlichen Rückgang von Anzahl und Schwere der Hitzewallungen. ABSTRACT: Many breast cancer patients suffer from the side-effects of endocrine therapy. Climacteric complaints with hot flashes, night sweats, sexual dysfunction, anxiety, depression and musculoskeletal pain lead to a worsening of therapy adherence in many cases. Concurrent therapy with selective serotonin reuptake inhibitors (SSRIs), gabapentin or clonidine have been shown to be effective in several randomized clinical trials (RCT) but many patients refuse to use these medications because they are afraid of additional side-effects. Complementary therapies are popular but the quality and quantity of clinical research in this field has only increased relatively recently. The three RCTs with isolated soy isoflavones did not show superiority compared to placebo. In three out of five clinical studies with black cohosh a reduction of hot flashes was shown, in the fourth study there was no effect on hot flashes but sweating was reduced in the treatment group, in the fifth study there was no difference between verum and placebo. In a phase II study a daily intake of 40 g bruised flax seed reduced hot flashes by 50%. Nevertheless, a placebo-controlled study could not confirm these data. Homeopathic treatment was helpful in an observational study but positive effects were not reproducible in two following RCTs. In a recent meta-analysis of acupuncture in treating hot flashes in breast cancer patients, verum acupuncture was significantly more effective than sham acupuncture. Also a complex 8 week treatment group with yoga, meditation and breathing exercises reduced hot flashes in breast cancer patients and the results of two small pilot studies suggest that stellate ganglion block might also decrease the number and severity of hot flashes.
    09/2011; 26(5). DOI:10.1007/s12312-011-0678-3
  • K Hostanska · M Rostock · R Saller
    Planta Medica 08/2011; 77(12). DOI:10.1055/s-0031-1282787 · 2.34 Impact Factor

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