Boswellic acids in the palliative therapy of children with progressive or relapsed brain tumors

19 children and adolescents with intracranial tumors received a palliative therapy with H 15(R) at a maximum dose of 126 mg/kg BW/day. All patients had previously been treated with conventional therapy. No side effects were observed during a median 9 months application. The recently reported antiedematous effect of H 15(R) was documented by MRI in one patient with a peritumoral edema, thus sparing steroid therapy with its typical side effects. Five/19 children reported an improvement of their general health status: this might be a psychological effect of hope for tumor response during palliative care. Three/17 patients with malignant tumors showed a mainly transient improvement of neurological symptoms such as pareses and ataxia. Three further patients showed an increased muscular strength and one cachectic patient achieved a weight gain. These improvements might be attributed to the antiedematous effect of H 15(R). Because of the palliative situation of these patients, H 15(R) application was performed without prior rebiopsy for histological evaluation. Overlapping effects with a previous radiotherapy or chemotherapy may have occurred. An antiproliferative effect cannot be stated. To prevent an uncritical use of H 15(R), further studies with prospective central documentation have to be initiated to evaluate the clinical indications for H 15(R) in palliative therapy, optimal dosage and duration of application.