[Chemotherapy and palliation in patients with advanced cancer]

Chemotherapy shows antitumoral activity in several advanced cancers. However, toxicity is frequent and may even overwhelm the clinical benefit of antineoplastic activity. To recommend such a treatment, we need to know the sensibility of cancer to therapy, its toxic effects and the clinical benefit we are looking for, expressed as: symptoms relief or delay in its presentation, improvement in quality of life, increase in overall survival and reduction in tumor volume. We need also to evaluate the performance status and functional status of each patient, its prognosis, the severity of symptoms and its interest to receive any antitumor treatment. According to these parameters we can individualize each therapy to select those patients whose expected benefit from this palliative chemotherapy is higher.