William J. Gradishar, MD; Martin S. Tallman, MD
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Gradishar WJ, Tallman MS. High-Dose Chemotherapy for Breast Cancer. Ann Intern Med. 1997;126:918. doi: 10.7326/0003-4819-126-11-199706010-00023
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Published: Ann Intern Med. 1997;126(11):918.
We appreciate the correspondence from Dr. Rushing and de Vries and colleagues. We understand Dr. Rushing's point that some physicians believe that there is adequate evidence from phase II trials to justify the use of a new therapy without confirmation from a phase III randomized trial comparing the current standard therapy to the new treatment. However, we believe it is premature to assume that high-dose chemotherapy is superior to conventional-dose chemotherapy for women with high-risk early-stage breast cancer, despite the encouraging preliminary data cited by Peters and colleagues . Few long-term outcome data (survival) or toxicity data for treatment with high-dose chemotherapy in women with high-risk, early-stage breast cancer are available. We believe it is prudent to proceed cautiously because an emerging literature describes the long-term toxicities (such as myelodysplasia and acute leukemias) associated with high-dose chemotherapy and autologous stem cell transplantation [2, 3].
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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