PMID- 1285731
OWN - NLM
STAT- MEDLINE
DCOM- 19920423
LR  - 20170210
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 10
IP  - 4
DP  - 1992 Apr
TI  - High-dose chemotherapy with autologous bone marrow transplantation for the 
      treatment of metastatic breast cancer.
PG  - 657-70
AB  - PURPOSE: This review was undertaken to examine the evidence of effectiveness of 
      high-dose chemotherapy and autologous bone marrow transplantation (HDC/ABMT) for 
      the treatment of metastatic breast cancer and to compare the magnitudes of the 
      benefits and harms of HDC/ABMT with those of conventional doses of chemotherapy. 
      DESIGN: Published studies were reviewed and analyzed. RESULTS: No randomized 
      controlled trials have been published that evaluate HDC/ABMT. Only one internally 
      controlled study has been conducted; it demonstrated that HDC/ABMT and 
      conventional treatment have virtually identical outcomes. Comparisons of 
      uncontrolled clinical series are confounded by patient selection and other 
      biases. Gross comparisons indicate that, compared with conventional-dose 
      chemotherapy, HDC/ABMT achieves (1) higher complete response rates (36% v 8%), 
      (2) higher overall response rates (70% v 39%), (3) similar median response 
      durations (8 months v 9.6 months), (4) similar median survival durations (16 
      months v 16.6 months), and (5) similar overall survival rates (eg, 43% 2-year 
      survival v 39%). Observations of cases with longer-term disease-free survival are 
      promising but not conclusive. High-dose chemotherapy with ABMT has a higher 
      treatment-related mortality rate (5% to 15% v 1%), a high rate of nonmortal 
      toxicity (approximately 30%), and a high rate of side effects (approaching 100%). 
      CONCLUSIONS: Firm conclusions are not possible because of the lack of controlled 
      studies and the presence of numerous biases. However, the existing evidence does 
      not demonstrate that HDC/ABMT is superior to conventional-dose chemotherapy for 
      the treatment of metastatic breast cancer. Randomized controlled trials are 
      needed.
FAU - Eddy, D M
AU  - Eddy DM
AD  - Center for Health Policy, Research, and Education, Duke University, Durham, NC.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
EIN - J Clin Oncol 1992 Oct;10(10):1655-8
CIN - J Clin Oncol. 1992 Oct;10(10):1652-3; author reply 1653-4. PMID: 1403045
CIN - J Clin Oncol. 1992 Oct;10(10):1653-4. PMID: 1403046
CIN - J Clin Oncol. 1992 Apr;10(4):517-9. PMID: 1548515
MH  - *Bone Marrow Transplantation
MH  - Breast Neoplasms/drug therapy/mortality/pathology/surgery/*therapy
MH  - Carcinoma/drug therapy/mortality/secondary/surgery/*therapy
MH  - Combined Modality Therapy
MH  - Female
MH  - Humans
MH  - Randomized Controlled Trials as Topic
MH  - Survival Analysis
MH  - Transplantation, Autologous
RF  - 128
EDAT- 1992/04/01 00:00
MHDA- 1992/04/01 00:01
CRDT- 1992/04/01 00:00
PHST- 1992/04/01 00:00 [pubmed]
PHST- 1992/04/01 00:01 [medline]
PHST- 1992/04/01 00:00 [entrez]
AID - 10.1200/JCO.1992.10.4.657 [doi]
PST - ppublish
SO  - J Clin Oncol. 1992 Apr;10(4):657-70. doi: 10.1200/JCO.1992.10.4.657.