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. 2009;4(3):162-165.
doi: 10.1159/000222333. Epub 2009 Jun 23.

Is Higher Efficacy Always at the Price of More Side Effects during Chemotherapy?

Brigitte Mlineritsch  1
Affiliations

Is Higher Efficacy Always at the Price of More Side Effects during Chemotherapy?

Brigitte Mlineritsch. Breast Care (Basel). 2009.

Abstract
in English, German

Breast cancer remains the most prevalent cancer diagnosed in women worldwide. The number of effective treatments for breast cancer is on the rise, however, the benefit from specific treatments to individual patients and the adverse events experienced vary considerably. Efficacy and safety of anticancer therapies may depend on tumor, treatment, and host characteristics. Advances in the adjuvant chemotherapy of operable breast cancer have come from the introduction of effective agents and the application of the principles of combination chemotherapy. Attempts to advance these principles by substantial escalation of drug dosage have proven unsuccessful with a potentially higher rate of side effects. Another concept to increase efficacy is dose density, the administration of drugs with shortened intertreatment interval, and sequential therapy. The dose-dense concept improved clinical outcome significantly and was not accompanied by an increase in toxicity.

Das Mammakarzinom ist nach wie vor das häufigste Karzinom der Frau weltweit. Die Zahl der wirksamen Therapien steigt, jedoch ist der Gewinn von einzelnen Therapien und deren Nebenwirkungen für die individuelle Patientin sehr unterschiedlich. Wirksamkeit und Nebenwirkungen der Chemotherapie hängen von Cha-rakteristika des Tumors, aber auch von Eigenheiten der Therapie und der Patientin ab. Fortschritte in der adjuvanten Chemotherapie des primär operablen Mamma-karzinoms wurden durch die Einführung neuer Substanzen und durch die Verabreichung einer Kombinationschemotherapie erzielt. Versuche, diese Fortschritte durch Dosiseskalation zu verbessern, erwiesen sich als erfolglos mit beträchtlicher Zunahme der Nebenwirkungen. Ein anderer Weg, die Effektivität zu erhöhen, ist das Dose-dense-Prinzip, in dem die Intervalle zwischen den Chemotherapien verkürzt werden, und die sequentielle Verabreichung der Zytostatika. Das Dose-dense-Prinzip erwies sich der konventionellen Verabreichung signifikant überlegen, ohne Zunahme der Nebenwirkungen.

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