By M. H. N. Tattersall (auth.), Professor Dr. Hans-Jörg Senn, Priv.-Doz. Dr. Aron Goldhirsch, Dr. Richard D. Gelber, Dr. Bruno Osterwalder (eds.)
The final "consumer" of the information offered at meetings at the fundamental remedy of operable breast melanoma is the sufferer, and while, as during this disorder, the advantages of treatment are rather mod est, the supply and interpretation of the knowledge from trials be comes a topic of fundamental value. the consequences of current deal with ment are actually such that extra sufferers relapse regardless of treatment than are predicted to profit from it. it's, for this reason, tremendous dif ficult for the health practitioner to suggest unequivocally one specific adjuvant therapy modality for the huge inhabitants of girls with breast melanoma. the translation of effects from scientific research-oriented seasoned grams is consistently utilized, besides the fact that, within the therapy of breast melanoma sufferers open air of medical trials. From provided or submit ed info, many physicians extrapolate symptoms for using a given therapy routine for his or her sufferers, perceiving it because the "best to be had remedy. " it truly is crucial that the "best on hand treatment" be chosen separately for every sufferer. in spite of the fact that, contemplating the modest impact of therapy upon final result, it truly is important that those that give you the information - those people who are focused on either pa tient care and medical examine - make it recognized that the easiest cur lease therapy for the inhabitants of breast melanoma sufferers is avail capable in the framework of scientific trials. during this method not just present-day sufferers but additionally destiny ones will derive the best benefit.
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Additional info for Adjuvant Therapy of Primary Breast Cancer
More recently completed studies documenting the safety of more dose-intensive preoperative chemotherapy with anthracycline (Hortobagyi et al. 1987; Lippman et al. 1986b; Ragaz et al. 1987 a) revived previous interest, resulting at present in a quest for a more organized approach towards neoadjuvant therapy (Jacquillat et al. 1986; Ragaz et al. 1986; Ragaz 1986a; Wagner et al. 1985). As larger randomized studies are planned, the rationale for the more complex approach must be clear, not only to the investigators, but also to the practitioners and their patients.
CpF; C, cyclophosphamide; v, CMFV; 0, CMF; CPl, CpMF; CP, phenylalanine mustard; --, trial with radiotherapy added; levels of CMF chemotherapy according to Bonadonna *, c;. 0 DOSE INTENSITY 20 W. M. Hryniuk PREMENOPAUSAL (1-3n) 100 PREMENOPAUSAL (>3n) A B 90 80 cp I/) 70 a: > 60 u. a: C. 'i> 09 q. • . ',; ~ • M <;; 50 ;; c. 0 DOSE INTENSITY Fig. 3 A, B. Stage II carcinoma of the breast: 3-year relapse-free survival versus average relative dose intensity for adjuvant chemotherapy in women under 50.
Cancer Treat Rep 60: 1749-1760 Skipper HE (1983) Some thoughts on the design and redesign of combination chemotherapy regimens for treating disseminated breast cancer. Ann Arbor, University Microfilms International 6: 3-61 Slamon OJ, Clark GM, Wong SG (1987) Human breast cancer: correlation of relapse and survival with amplification of the HER-2 NEU oncogene. Science 235: 177-182 Sporn MB, Roberts AB (1985) Autocrine growth factors in cancer. Nature 313: 745-747 Thorpe SM, Rose C, Rasmussen BB et al.