High-dose chemotherapy: studies on supportive care, quality of life and late effects of treatment

Drug resistance is a major problem in the treatment of malignancies. Based on steep dose-response relationship for certain chemotherapeutic drugs in vitro on tumor cell survival, high-dose chemotherapy was considered of interest for the treatment of malignancies. Introduction of autologous bone-marrow toxic chemotherapy while thereafter the bone-marrow was rescued. Initially there were high expectations for the application in solid tumors. Nowadays, following numerous phase 2 and a number of phase 3 studies its precise role in solid tumors is unknown. Therefore, the meta-analysis of especially high-dose chemotherapy in the adjuvant breast cancer setting is eagerly awaited. High-dose chemotherapy induces considerable morbidity. The balance between side effects and survival benefit will finally determine the indication(s) for this treatment modality in solid tumors. This thesis aims to give in depth insight in a number of short-term and long-term side effects that are consequences of high-dose chemotherapy.