Supplementary Material for: Integrative oncology approach in advanced myxofibrosarcoma: a case report of prolonged survival with high-dose Vitamin C and Viscum Album

Introduction: Myxofibrosarcoma is a rare and aggressive soft tissue sarcoma with high recurrence and metastasis rates. The prognosis in advanced metastatic disease is poor, with median survival time ranging from 12 to 24 months despite multimodal therapy. Integrative oncology approaches, such as high-dose vitamin C and Viscum album, are increasingly explored as adjuncts in both curative and palliative cancer care. Objective: To describe the clinical course and outcomes of a patient with advanced unresectable myxofibrosarcoma treated with conventional and complementary oncology strategies. Case Presentation: We present the case of a 59-year-old male with high-grade myxofibrosarcoma of the right buttock and spinal metastases. Standard palliative treatments (systemic chemo and radiotherapy, followed by targeted and immunotherapy) were combined with high-dose intravenous vitamin C and Viscum album extracts given intravenously, subcutaneously, and intratumorally. Results: Despite the progression of the disease and COVID-19 comorbidity, the patient survived for 48 months, exceeding conventional survival estimates. Conclusion: This case suggests that integrative oncology combining systemic anticancer therapy with high-dose vitamin C and Viscum album extracts may enhance tolerance and extend survival in advanced myxofibrosarcoma. Further prospective studies are warranted to corroborate the value of complementary therapy in sarcoma management.引言：黏液纤维肉瘤（myxofibrosarcoma）是一种罕见且侵袭性强的软组织肉瘤，复发与转移率较高。晚期转移性患者预后不良，即便接受多模式治疗，中位生存期仍仅为12~24个月。整合肿瘤学（integrative oncology）手段，如大剂量维生素C疗法与槲寄生（Viscum album）疗法，正日益被探索作为根治性与姑息性癌症治疗的辅助方案。 研究目的：描述1例晚期不可切除黏液纤维肉瘤患者接受常规肿瘤治疗与补充肿瘤治疗联合方案后的临床病程与转归。 病例介绍：本研究报告1例59岁男性患者，其右侧臀部罹患高级别黏液纤维肉瘤，且合并脊柱转移瘤。临床中将标准姑息治疗（全身化疗、放疗，后续联合靶向治疗与免疫治疗）与大剂量静脉注射维生素C、经静脉、皮下及瘤内途径给药的槲寄生提取物联合应用。 结果：尽管疾病出现进展且合并新型冠状病毒肺炎（COVID-19），该患者的生存时长仍达到48个月，超出了常规生存预期。 结论：本病例提示，将全身抗癌治疗与大剂量维生素C、槲寄生提取物联合的整合肿瘤学方案，或可提高晚期黏液纤维肉瘤患者的治疗耐受性并延长生存时间。未来需开展前瞻性研究以验证补充治疗在肉瘤管理中的临床价值。