Principles of preoperative chemotherapy

Abstract

Efficacy of preoperative (primary, neoadjuvant) systemic chemotherapy significantly improved over the last two decades. Only about 3% of patients reached a pathological complete remission after preoperative treatment with cyclophosphamide, methotrexate and 5-fluorouracil in the late 1980s, whereas today up to 18% have no viable tumour cell detected at histological examination when taxane-containing regimens, for example adriamycin/cyclophosphamide followed by docetaxel or docetaxel/adriamycin/cyclophosphamide, are being used. This improvement has implications on current treatment recommendations and should be considered when this approach gains a broader use in routine practice.