In patients with widespread disease, chemotherapy with new drugs offers improved survival.
Treatment has also improved since 1998, particularly more widespread adjuvant chemotherapy, and pre-operative radiotherapy in rectal cancer.
The incidence of aspergillosis has increased during the past two decades due to widespread use of chemotherapy and immunosuppressive agents, and is a frequently lethal complication of acute leukemia patients that occurs following both chemotherapy and bone marrow transplantation (BMT) [ 1].
The efficacy of this treatment led to the widespread realization that chemotherapy for cancer could be effective.
Fortunately, breast cancer mortality in the Western world has dropped dramatically over the last 30 years, in part because of widespread application of chemotherapy and, importantly, therapies that target estrogen and, more recently, HER2.
However, only 3 of the 8 guidelines for each of the latter types of tumors had some caveats and were not openly committed to widespread use of chemotherapy in these patients.
This indicates that in widespread locoregional disease chemotherapy alone inadequately eliminates metastatic disease and an additional therapeutic effect is achieved by locoregional therapy.
There remained a widespread belief that chemotherapy for lung cancer was toxic and ineffective and a survey of clinicians who treated lung cancer in the United Kingdom found little support for chemotherapy (Crook et al, 1997).
Methylating agents are in widespread use in chemotherapy, in part, due to their ability to kill apoptosis-resistant cells such as follicular lymphoma (Lister, 1991; Zong et al, 2004; Amaravadi and Thompson, 2007).
The current challenges in its chemotherapy include widespread resistance to pentavalent antimony; absence of safe and cost-effective antileishmanial agents and relapses in HIV Leishmania co-infected patients.
