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June 12, 1967

The Place of Chemotherapy in Management

JAMA. 1967;200(11):976. doi:10.1001/jama.1967.03120240104019

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Chemotherapy is not specific. It differs fundamentally from hormone therapy which is directly dependent on the hormone sensitivity of the tumor. This lack of specificity depresses the mitotic activity of all rapidly multiplying normal cells such as those of the hemopoietic bone marrow and the epithelium of the gastrointestinal tract. The magnitude of this antimitotic activity on normal cells can be serious and is often unpredictable.

The choice of methods of administration is dictated by the widespread nature of the disease. Isolated perfusion for recurrence in the breast area or a previously untreated primary lesion is of little value, as there is no major cannulable arterial supply to the breast and innominate or subclavian cannulation21 is even too localized for the distribution of the disease. It might, however, be an adjunct to parenteral therapy when there is a concentration of metastases at a site or in an organ with