title: [Dose density and dose intensity in the treatment of breast cancer].
abstract: Since 10 years, high-dose chemotherapy has been evaluated for the treatment of breast cancer in numerous randomized clinical trials. Preliminary results of some of these studies have shown an advantage in relapse-free survival in both metastatic and high-risk breast cancer. Although follow-up is short in most of the studies, no impact on overall survival has been detected. Based on available results, high-dose chemotherapy cannot be proposed either in metastatic or in high-risk breast cancer patients outside a clinical trial. Conversely, two randomized trials have demonstrated that dose-dense scheduled chemotherapy with G-CSF support, containing an anthracycline, cyclophosphamide and paclitaxel, improves clinical outcomes compared with the same regimen administered every 3 weeks. These results establish dose-dense scheduled chemotherapy containing an anthracycline and paclitaxel as an option for the adjuvant treatment of positive lymph nodes breast cancer patients. Data are not sufficient to conclude in the neoadjuvant and metastatic setting. High-dose chemotherapy and dose-dense chemotherapy seem to increase the pathological complete response rate in inflammatory breast cancer. However, prospective and comparative survival data are lacking.
authors.affiliation: Service d'oncologie médicale, hôpital Avicenne, 125 rue de Stalingrad, 93009 Bobigny. pierre.saintigny@avc.ap-hop-paris.fr
authors.forename: Pierre
authors.initials: P
authors.lastname: Saintigny
authors.forename: Sabine
authors.initials: S
authors.lastname: Assouad
authors.forename: Joseph
authors.initials: J
authors.lastname: Gligorov
authors.forename: Frédéric
authors.initials: F
authors.lastname: Selle
authors.forename: Henri
authors.initials: H
authors.lastname: Roché
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Breau
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Morère
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lotz
mesh_terms: D018943:Anthracyclines / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D017239:Paclitaxel