Dose-Dense Chemotherapy: Principles, Clinical Results and Future Perspectives
- PMID: 21076605
- PMCID: PMC2974980
- DOI: 10.1159/000148914
Dose-Dense Chemotherapy: Principles, Clinical Results and Future Perspectives
Abstract
The dose intensity of adjuvant chemotherapy for breast cancer is an important predictor of clinical outcome. Dose-dense chemotherapy increases the dose intensity of the regimen by delivering standard-dose chemotherapy with shorter intervals between the treatment cycles. The rationale for dose-dense therapy stems from the Norton-Simon hypothesis: Sequential, consecutive dosing of chemotherapy using single or a combination of agents increases the dose density over alternating dosing, improving results. Supporting adjuvant studies, such as C9741, and the ensuing clinical experience indicate an improved disease-free and overall survival. Dosedense adjuvant chemotherapy improves clinical outcomes without increasing toxicity.
Die Dosisintensität einer adjuvanten Chemotherapie gegen Brustkrebs ist ein wichtiger Indikator des klinischen Effekts. Dosisdichte Chemotherapie erhöht die Dosisintensität des Behandlungsregimes, indem die Standarddosis-Chemotherapie in kürzeren Intervallen zwischen den Behandlungszyklen angewendet wird. Das Grundprinzip der dosisdichten Therapie basiert auf der Norton-Simon-Hypothese: Serielle, aufeinanderfolgende Dosierung der Chemotherapie mit einzelnen oder kombinierten Wirkstoffen erhöht die Dosisdichte gegenüber der alternierenden Dosierung und verbessert so das Ergebnis. Unterstützende adjuvante Studien, wie z.B. C9741, und die daraus folgenden klinischen Erfahrungen zeigen ein verbessertes krankheitsfreies und Gesamtüberleben. Dosisdichte adjuvante Therapie verbessert den klinischen Effekt, ohne die Toxizität zu erhöhen.
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