[Relation dose efficacy in chemotherapy: the example of breast cancer]

The efficacy of cytotoxic chemotherapy when administered at conventional doses in breast cancer is limited and allows to understand some failures in the adjuvant, advanced or inflammatory and also in metastatic settings. The use of high dose chemotherapy is one way to try to improve its efficacy based on response rate, overall and disease free survival. Retrospective analysis on dose efficacy in breast cancer suggest that the results obtained by cytotoxic chemotherapy are linked to the administered dose without being able to assess this hypothesis with certainty. In 1995, the concept of dose efficacy remains to be validated by the appropriate prospective randomized trials.