Several strategies have been implemented in order to develop effective treatment intensification schedules.
These clinical perspectives, which might eventually facilitate chemotherapy dose and schedule intensification, call for the development of new, selective H4R agonists.
Since then, outcome for patients with rhabdomyosarcoma, osteosarcoma and Ewing sarcoma has improved dramatically thanks to intensification of treatment schedule, better supportive care and local therapy or use of risk stratification for rhabdomyosarcoma, [ 5- 8].
While recent years have seen various approaches to improve outcome by intensification of treatment schedules through introduction of novel induction and combination chemotherapy regimen and altered fractionation regimen, patient tolerance to higher treatment intensities is limited by accompanying side-effects.
The schedule of intensification of mIBG therapy by dose escalation and radiosensitisation with topotecan with a haematopoietic autograft has been shown to be safe and practicable [ 29].
Several variations of this regimen, incorporating oxaliplatin dose intensification or simplification of the LV/5-FU schedule, have been evaluated in clinical trials.
These include intensification of the routine programme to complete vaccination schedules: polio eradication campaigns, catch-up vaccination activities.
Subsequently, Schedule C was added, to assess whether dose intensification, relative to Schedule B, might improve antileukaemic activity without losing the tolerability of the 2-dose schedule; two doses (72 and 90 mg/m) were evaluated for this schedule.
Therefore, a number of clinical research efforts are currently being undertaken in order to enhance the therapeutic effectiveness of front-line chemotherapy in advanced disease, including modification of the administration schedule of gemcitabine (Temporo et al, 1999), dose intensification (Ulrich-Pur et al, 2000), and/or its combination with other drugs and biologicalsQ1 (Heinemann, 2002).
Patients in the control group are scheduled for appointments if they feel they need medication intensification.
