Banys-Paluchowski M, Schütz F, Ruckhäberle E, Krawczyk N, Fehm T
Department of Gynecology and Obstetrics, Marienkrankenhaus Hamburg, Hamburg.
Department of Gynecology and Obstetrics, Heidelberg University Hospital, University of Heidelberg, Heidelberg.
Geburtshilfe Frauenheilkd. 2016 May;76(5):525-534. doi: 10.1055/s-0042-105871.
Conventional chemotherapy is generally administered in high doses followed by a treatment-free period to give the body needful time to recover. This "maximum tolerated dose" approach results in high response rates. However, long periods between therapy cycles can lead to development of resistance mechanisms and consequently disease progression. One of the most interesting alternative strategies is metronomic chemotherapy. This concept relies on the continuous administration of chemotherapy at low doses and aims at targeting endothelial cells in the tumor bed as well. Recently, metronomic chemotherapy has been incorporated into the recommendations issued by the German AGO expert panel (www.ago-online.de). A systematic review of PubMed/Medline, ClinicalTrials.gov, the European Clinical Trials Database (EudraCT) and the Cochrane Database was conducted. In the present review, we discuss the current evidence on metronomic chemotherapy in metastatic breast cancer.
传统化疗通常采用高剂量给药，随后是无治疗期，以便身体有足够时间恢复。这种“最大耐受剂量”方法可带来较高的缓解率。然而，治疗周期之间的长时间间隔会导致耐药机制的形成，进而导致疾病进展。最有趣的替代策略之一是节拍化疗。这一概念依赖于低剂量持续给予化疗，其目标还包括肿瘤床中的内皮细胞。最近，节拍化疗已被纳入德国AGO专家小组发布的建议中（www.ago-online.de）。我们对PubMed/Medline、ClinicalTrials.gov、欧洲临床试验数据库（EudraCT）和考克兰数据库进行了系统综述。在本综述中，我们讨论了转移性乳腺癌节拍化疗的当前证据。
