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Adjuvant Chemotherapy for Cancer: A Point of View

Adjuvant Chemotherapy for Cancer: A Point of View Abstract Adjuvant chemotherapy in the treatment of cancer is suddenly fashionable. A recent editorial in the New England Journal of Medicine1 has the title, "Major Advance in Breast Cancer Therapy," and does not follow the bold statement with a question mark. The writer of the editorial advocated that adjuvant chemotherapy should be given to all patients with early breast cancer without awaiting the outcome of further research. To give chemotherapy soon after the removal of a malignant neoplasm is an attractive approach from several aspects. It seems logical to use cytotoxic agents when residual tumor cells are minimal, and recent experience with both leukemia and Wilms tumors suggests that continuing chemotherapy against subclinical disease can be remarkably successful. As well, some experimental work with animal models has demonstrated that early chemotherapy can cure micrometastases. Undoubtedly the greatest factor in bringing adjuvant therapy into the spotlight has been the recent publication References 1. Holland JF: Major advance in breast-cancer therapy . N Engl J Med 294:440-441, 1976.Crossref 2. Fisher B, Carbone P, Economou SG, et al: 1-Phenylajanine mustard (L-PAM) in the management of primary breast cancer: A report of early findings . N Engl J Med 292:117-122, 1975.Crossref 3. Bonadonna G, Brusamolino E, Valagussa V, et al: Combination chemotherapy as an adjuvant treatment in operable breast cancer . N Engl J Med 294:405-410, 1976.Crossref 4. Costanza ME: Sounding board: The problem of breast cancer prophylaxis . N Engl J Med 293:1095-1098, 1975.Crossref 5. Fisher B, Slack NH, Bross DJ: Cancer of the breast: Size of neoplasm and prognosis . Cancer 24:1071-1080, 1969.Crossref 6. Holyoke ED, Gerner RE, Elias EG: Nonoperative treatment of solid tumours . Adv Surg 7:1-44, 1973. 7. Finney RE: Adjuvant chemotherapy in the radical treatment of carcinoma of the breast: A clinical trial . Am J Roentgenol 111:137-141, 1971.Crossref 8. Shingleton WW: Section meeting of new approaches to therapy: Surgery . Am J Dig Dis 19:1056-1058, 1974.Crossref 9. Lawrence WJ, Terz JJ, Horsley JS, et al: Chemotherapy as an adjuvant to surgery for colorectal cancer . Ann Surg 181:616-623, 1975.Crossref 10. Cole MP: Depression of ovarian function in primary breast cancer , in Forrest APM, Kumbler PB (eds): Prognostic Factors in Breast Cancer . Edinburgh, E & S Livingstone Ltd, 1968. 11. Donegan WL: Extended surgical adjuvant thiotepa for mammary carcinoma . Arch Surg 109:187-192, 1974.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Adjuvant Chemotherapy for Cancer: A Point of View

Archives of Surgery , Volume 112 (2) – Feb 1, 1977

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Publisher
American Medical Association
Copyright
Copyright © 1977 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1977.01370020013001
Publisher site
See Article on Publisher Site

Abstract

Abstract Adjuvant chemotherapy in the treatment of cancer is suddenly fashionable. A recent editorial in the New England Journal of Medicine1 has the title, "Major Advance in Breast Cancer Therapy," and does not follow the bold statement with a question mark. The writer of the editorial advocated that adjuvant chemotherapy should be given to all patients with early breast cancer without awaiting the outcome of further research. To give chemotherapy soon after the removal of a malignant neoplasm is an attractive approach from several aspects. It seems logical to use cytotoxic agents when residual tumor cells are minimal, and recent experience with both leukemia and Wilms tumors suggests that continuing chemotherapy against subclinical disease can be remarkably successful. As well, some experimental work with animal models has demonstrated that early chemotherapy can cure micrometastases. Undoubtedly the greatest factor in bringing adjuvant therapy into the spotlight has been the recent publication References 1. Holland JF: Major advance in breast-cancer therapy . N Engl J Med 294:440-441, 1976.Crossref 2. Fisher B, Carbone P, Economou SG, et al: 1-Phenylajanine mustard (L-PAM) in the management of primary breast cancer: A report of early findings . N Engl J Med 292:117-122, 1975.Crossref 3. Bonadonna G, Brusamolino E, Valagussa V, et al: Combination chemotherapy as an adjuvant treatment in operable breast cancer . N Engl J Med 294:405-410, 1976.Crossref 4. Costanza ME: Sounding board: The problem of breast cancer prophylaxis . N Engl J Med 293:1095-1098, 1975.Crossref 5. Fisher B, Slack NH, Bross DJ: Cancer of the breast: Size of neoplasm and prognosis . Cancer 24:1071-1080, 1969.Crossref 6. Holyoke ED, Gerner RE, Elias EG: Nonoperative treatment of solid tumours . Adv Surg 7:1-44, 1973. 7. Finney RE: Adjuvant chemotherapy in the radical treatment of carcinoma of the breast: A clinical trial . Am J Roentgenol 111:137-141, 1971.Crossref 8. Shingleton WW: Section meeting of new approaches to therapy: Surgery . Am J Dig Dis 19:1056-1058, 1974.Crossref 9. Lawrence WJ, Terz JJ, Horsley JS, et al: Chemotherapy as an adjuvant to surgery for colorectal cancer . Ann Surg 181:616-623, 1975.Crossref 10. Cole MP: Depression of ovarian function in primary breast cancer , in Forrest APM, Kumbler PB (eds): Prognostic Factors in Breast Cancer . Edinburgh, E & S Livingstone Ltd, 1968. 11. Donegan WL: Extended surgical adjuvant thiotepa for mammary carcinoma . Arch Surg 109:187-192, 1974.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Feb 1, 1977

References