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The Status of High-Dose Chemotherapy in Breast Cancer

Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

Correspondence: S. Rodenhuis, M.D., Ph.D., The Netherlands Cancer Institute, Department of Medical Oncology, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. Telephone: 31-20-512-2870; Fax: 31-20-512-2572; e-mail: sroden{at}nki.nl

High-dose chemotherapy in breast cancer is a subject of considerable controversy. Preliminary results from several randomized trials have shown that it is certainly not the breakthrough hoped for in the early 1990s. The available data are, however, compatible with a modest but potentially important effect on relapse-free survival in the adjuvant treatment of high-risk breast cancer. To prove such an effect, several more years of maturation are required for a number of randomized studies. At this point in time, there is no justification for the use of high-dose chemotherapy in breast cancer outside clinical studies.

Key Words. Breast cancer • High-dose chemotherapy • Adjuvant chemotherapy • Cyclophosphamide • Thiotepa • Carboplatin • Carmustine (BCNU) • Stem cell transplantation • Bone marrow transplantation

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