Utilized in breast cancer adjuvant chemotherapy shortening treatment intervals from three to two weeks.
Based on fact that breast cancer cells exhibit nonexponential Gompertzian growth and regrowth between chemotherapy cycles increases as tumor size decreases.
Contraction of chemotherapy regimen produces greater cell kill and decreases tumor regrowth to more effectively eliminate residual disease.
A less cell-dense tissue has a lower fractal dimension than a tissue with a higher cell density.
Dose dense adjuvant chemotherapy for breast cancer results in a 4-year disease free survival of 82% vs. 75% with conventional therapy.
Intergroup Trial of doxorubicin plus cyclophosphamide for 4 cycles every two weeks followed by paclitaxel for 4 cycles with colony stimulating factor resulted after a median follow-up of 6.5 years with a hazard ratio for disease free survival of 0.75.
Treatment with dose dense epirubicin/taxol plus cyclophoshamide chemotherapy in high risk early stage breast cancer in a randomized phase III trial of nearly 1,300 patients with a median of 8 positive axillary lymph nodes (German AGO Group) was superior to standard therapy in survival free relapse and overall survival , 70% vs 62%, and 82% vs 72%, respectively.
Risk of relapse reduced only demonstrated for ER negative patients with no discernible benefit for ER positive patients.
With 5FU, epirubicin and cyclophosphamide no demonstrated benefits in adjuvant breast cancer therapy were noted over conventional treatment schedule.