[Intensification of chemotherapy dosage in metastatic breast carcinoma?]

During the last decades, improvements in the median survival time in patients with metastasized carcinoma of the mamma were hardly achieved. There ist still a lack of evidence that the increase in the rate of remissions due to conventional chemotherapy leads to an improvement in survival time. In 450 female patients with metastasized carcinoma of the mamma, the survival time was analyzed with the begin of the metastatic spread in relation to the treatment success of the first palliative chemotherapy. The survival time of the responder group was not significantly different to the group with a stationary tumor (p = 0.5). As patients with primary hormone therapy were included, this result changed if patients only with prognostically unfavorable characteristics (high-risk group) were selected, which received primarily and exclusively a cytostatic chemotherapy. The responder only (partial and complete responder) are profitting from the chemotherapy with a significant increase in survival time in comparison to the group with a stationary tumor (p = 0.02 and p = 0.006). Therefore, a stationary tumor in the high risk group is a result as bad as tumor progression.