Abstract
There are a number of important factors that may contribute to a decrease in effectiveness of therapy against disseminated disease. A primary factor is the absolute increase in body burden of tumor cells [14, 25]. With an increase in the number of tumor cells a greater demand is made on the amount of drug that is necessary to elicit the desired therapeutic response. It was demonstrated with leukemia L 1210, for example, that as the inoculum level was increased, the dose of methotrexate also had to be increased to maintain a given level of therapeutic response (ED50; 50% cures [14]. In another study it was observed that the number of cures that could be obtained on treatment with cyclophosphamide or 1,3-bis-(2-chloro-ethyl)-1-nitrosourea (BCNU) was diminished as the inoculum size was increased [7]. As the disease becomes more advanced there may be a reduction in the percentage cures that can be obtained over a variety of treatment schedules. Delay in treatment with cytosine arabinoside until the leukemia L 1210 disease was advanced (7 days following leukemic inoculation) resulted in a decrease in percentage cures as compared with treatment initiated early (day 3) on a variety of treatment schedules including treatment four times daily, twice daily, daily, every 2 days, or every 4 days as well as single treatment [8].
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Goldin, A., Nicolin, A., Bonmassar, E. (1979). Interrelationship Between Chemotherapy and Immunotherapy in the Treatment of Disseminated Disease. In: Bonadonna, G., Mathé, G., Salmon, S.E. (eds) Adjuvant Therapies and Markers of Post-Surgical Minimal Residual Disease II. Recent Results in Cancer Research, vol 68. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-81332-0_67
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DOI: https://doi.org/10.1007/978-3-642-81332-0_67
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