Bartsch Rupert, Steger Guenther G
Department of Medicine I and Cancer Centre, Clinical Division of Oncology, Medical University of Vienna, Austria.
Breast Care (Basel). 2009;4(3):167-176. doi: 10.1159/000223360. Epub 2009 Jun 23.
Recent advances in adjuvant treatment of breast cancer have improved progression-free and overall survival. Optimal management of treatment-induced side effects has therefore gained further importance. This review cannot provide a comprehensive overview of treatment-related toxicity and its management, but focuses on important new developments in the field of supportive therapy. Erythropoietins, while highly effective in treating chemotherapy-induced anaemia, may have detrimental effects on outcome, and should only be used with the aim to reduce the number of whole blood transfusions. Granulocyte colony-stimulating factors were a prerequisite for development of dose-dense regimens, and are also necessary in many anthracycline/taxane combination regimens. A potential tumour-stimulating effect was not proven in solid cancers. For side effects of conventional chemotherapy, such as mucositis, nausea, or diarrhoea, regularly updated guidelines may improve symptom control. Overall, modern supportive treatment tools will further reduce treatment-related mortality and help increase quality of life.
乳腺癌辅助治疗的最新进展改善了无进展生存期和总生存期。因此，对治疗引起的副作用进行最佳管理变得更加重要。本综述无法全面概述治疗相关毒性及其管理，而是侧重于支持治疗领域的重要新进展。促红细胞生成素虽然在治疗化疗引起的贫血方面非常有效，但可能对治疗结果产生不利影响，仅应用于减少全血输注次数。粒细胞集落刺激因子是密集剂量方案发展的先决条件，在许多蒽环类/紫杉烷联合方案中也是必需的。在实体癌中未证实其具有潜在的肿瘤刺激作用。对于传统化疗的副作用，如粘膜炎、恶心或腹泻，定期更新的指南可能会改善症状控制。总体而言，现代支持治疗工具将进一步降低治疗相关死亡率，并有助于提高生活质量。
