Dr. Haupt in his letter to the editor criticizes the study reported by Stupp et al., which was published in JAMA in 2017. His legitimate criticism is that the study included a deficient control group, in the sense that randomization had taken place, but true blinding had not. This means that placebo effects became relevant. This criticism is absolutely justified. Comprehensive discussions about “tumor-treating fields” (TTF) therapy has taken place in the neuro-oncological specialty societies; ultimately true blinding, as demanded by Haupt, is not possible in the setting of any treatment that the patient can feel. The limitation of a possible placebo effect therefore stands. In spite of this limitation, TTF therapy has moved up to the rank of “standard therapy” in Israel and the USA. This means that the relevant state agencies as well as the large insurance companies ended up being convinced by the effectiveness of the treatment. In my opinion, the cautious but positive description in our article was therefore justified.
On behalf of the authors
Prof. Dr. med. Roland Goldbrunner
Klinik für Allgemeine Neurochirurgie
Zentrum für Neurochirurgie
Conflict of interest statement
Prof. Goldbrunner has served as a paid consultant for MagForce and has received reimbursement of meeting participation fees and of travel and accommodation expenses from Roche.
|1.||Stupp R, Taillibert S, Kanner A, et al.: Effect of tumor-treating fields plus maintenance temozolomide vs maintenance temozolomide alone on survival in patients with glioblastoma: a randomized clinical trial. JAMA 2017; 318: 2306–16 CrossRef MEDLINE PubMed Central|
|2.||Goldbrunner R, Ruge M, Kocher M, Weiß Lucas C, Galldiks N, Grau S: The treatment of gliomas in adulthood. Dtsch Arztebl Int 2018; 115: 356–64 VOLLTEXT|