Rodenhuis S, de Vries E G
Het Nederlands Kankerinstituut/Antoni van Leeuwenhoek Ziekenhuis, afd. Medische Oncologie, Amsterdam.
Ned Tijdschr Geneeskd. 1999 Apr 3;143(14):731-8.
High-dose chemotherapy for advanced solid malignancies has been the subject of many clinical studies. The replacement of autologous bone marrow transplantation by peripheral blood haematopoietic progenitor cell transplantation and other advances in supportive care have led to a considerable reduction of therapy-related mortality and morbidity. In certain rare disorders, such as germ cell tumours or pediatric sarcomas in adults, high-dose therapy is currently considered the therapeutic standard. It is likely that a subgroup of patients with high-risk or disseminated breast cancer can also benefit in terms of survival from this treatment modality, but final proof from randomized studies remains to be generated. On theoretical grounds, high-dose chemotherapy could also be effective in small cell lung cancer and ovarian cancer, and randomized studies to answer this question are in progress. Many investigators concur that high-dose chemotherapy often leads to dramatic cytoreduction in solid tumours, but only rarely achieves cure. Novel therapeutic modalities are required to control the residual microscopic disease.
大剂量化疗用于晚期实体恶性肿瘤一直是许多临床研究的主题。外周血造血祖细胞移植取代自体骨髓移植以及支持治疗的其他进展已使治疗相关的死亡率和发病率大幅降低。在某些罕见疾病中，如生殖细胞肿瘤或成人小儿肉瘤，目前大剂量治疗被视为治疗标准。高危或播散性乳腺癌患者中的一个亚组可能也会从这种治疗方式中在生存方面获益，但随机研究的最终证据仍有待得出。从理论上讲，大剂量化疗在小细胞肺癌和卵巢癌中也可能有效，目前正在进行回答这一问题的随机研究。许多研究者一致认为，大剂量化疗通常会使实体肿瘤显著减瘤，但很少能实现治愈。需要新的治疗方式来控制残留的微小病灶。
