Hayat M
Bull Cancer. 1984;71(4):281-6.
Once the need for adjuvant chemotherapy has been defined with precision, it is important to specify when it may be employed. Two factors determine the decision to use this form of therapy: a) the notion of the presence of malignant tumor, sensitive to chemotherapy (breast, bone ovary), b) knowledge of the elements of prognosis. The probability of relapse is estimated on the basis of these two latter points. Adjuvant chemotherapy is prescribed in cases where the risk of relapse is quite important, attaining 40 to 50 per cent. Its effectiveness can be assessed only with rigorous statistical rules. Randomization only permits a comparison of adjuvant chemotherapy to a control group. Certain errors must be avoided in the interpretation of the results: inaccurate analysis of results such as median comparisons; comparison of the number of deaths or the number of relapses; exclusion of patients after randomization. Only the comparison of the remission duration curves by a test adapted to the form of the curves (Log rank test or Weibull's test) seems justified.
一旦精确确定了辅助化疗的必要性，明确何时可以采用辅助化疗就很重要。有两个因素决定是否采用这种治疗方式：a）存在对化疗敏感的恶性肿瘤（乳腺癌、骨癌、卵巢癌）的概念，b）对预后因素的了解。基于后两点来估计复发概率。在复发风险相当高、达到40%至50%的情况下，会开辅助化疗的处方。其有效性只能通过严格的统计规则来评估。随机分组仅允许将辅助化疗与对照组进行比较。在结果解读中必须避免某些错误：对结果的不准确分析，如中位数比较；死亡人数或复发人数的比较；随机分组后排除患者。只有通过适合曲线形式的检验（对数秩检验或威布尔检验）来比较缓解持续时间曲线似乎才是合理的。
