Dose Intensity of Chemotherapy in Breast Cancer. Results of Clinical Studies
| Autor: | R. Zschaber, William Krüger, A.R. Zander, Nicolaus Kröger, K. Mross, W. Zeller, D.K. Hossfeld |
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| Rok vydání: | 1995 |
| Předmět: |
Oncology
Cancer Research Chemotherapy medicine.medical_specialty business.industry medicine.medical_treatment Mortality rate Hematology Disease medicine.disease Metastatic breast cancer Clinical trial medicine.anatomical_structure Breast cancer Internal medicine medicine Autologous transplantation Bone marrow business |
| Zdroj: | Oncology Research and Treatment. 18:419-428 |
| ISSN: | 2296-5262 2296-5270 |
| Popis: | The availability of hematopoietic growth factors, autologous bone marrow, and peripheral blood stem cells has led to numerous clinical studies in breast cancer studying the dose response of chemotherapy. Significant higher remission rate by increasing the dose of chemotherapy without hematopoetic factors were found in 7 of 12 randomized studies, but in only 3 of them the higher response rates were associated with survival benefit. Using hematopoetic growth factors like G-CSF or GM-CSF allows a 1.5fold dose increase of chemotherapy or shortening of the intervals between therapies. Such dose intensity in metastatic disease led up to a 80% response rate (complete remission/partial remission) without significant survival benefit. With support of bone marrow or peripheral blood stem cells (PBSC) an up to lOfold dose increase of chemotherapy is feasible. With such high-dose chemotherapy and bone marrow or PBSC support in metastatic breast cancer a complete remission rate of 50% can be reached with a median response duration of 10-15 months. After 2-3 years about 20% of the patients will be disease free. Using autologous bone marrow as support is associated with a 10% therapy-related mortality rate while using PBSC as support decreases this rate to less than 5%. If the higher remission rate of high-dose chemotherapy in comparison to conventional chemotherapy leads to a significant survival benefit, it still needs to be determined in prospective randomized studies. In patients with primary high-risk breast cancer ( > 10 lymph nodes involved) treating with high-dose chemotherapy and bone marrow support, 71% will be disease free after 5 years, but similar to the metastatic disease, up to now there are no data available of ongoing randomized studies comparing high-dose to conventional-dose chemotherapy. Currently high-dose chemotherapy in breast cancer cannot be recommended outside of clinical trials. |
| Databáze: | OpenAIRE |
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