Intensification of chemotherapy dosage in advanced breast cancer

Background: There has not been any marked improvement in median survival ti mes inpatients vith metastasized breast cancer in the past decades. We stil l lack evidence that increased remission rates as a result of conventional chemotherapy also improve;survival times. It was the aim of our retrospecti ve study to find out whether there is a subgroup of patients who gain survi val benefit by chemotherapy. Patients and Methods: In 450 patients with met astasized breast cancer the survival time was measured in relation to the r esult of the first palliative chemotherapy. Of this group, which included a lso patients who received hormone therapy as the first mode of treatment, t hose patients were Selected who got cytostatic chemotherapy as the first an d exclusive therapeutic measure for unfavorable prognostic features. Statis tical calculations were performed according to Wilcoxon's life-table method . Results: In the whole group of patients, survival time of responders did not differ significantly from survival time of patients with stable disease (p = 0.5). This result differed from the results in the subgroup of patien ts which received chemotherapy as the unique mode of treatment. In this gro up, responders (complete and partial responders) showed a significantly bet ter outcome (p=0.02 or 0.006) compared with patients with stationary diseas e. Conclusion: In patients with unfavorable prognostic features, stable dis ease is a result of treatment that is as bad as tumor progression. To gain a survival benefit in this group of patients, it therefore is necessary to achieve remission rates as high as possible.