The proceedings of a meeting held in Heidelberg, Germany on the use of cytotoxic drugs in the treatment of cancers over the last 20 years.

Over the last 20 years, the major advances in cancer therapy have been in the area of cytotoxic drugs. A number of cancers, including childhood leukaemia, Hodgkin's and non-Hodgkin's lymphomas, testicular cancer and certain tumours of the ovary, which were generally fatal, can now be cured with chemotherapy. Ironically, it is the success of the cytotoxic agents in prolonging survival that has exposed their inherent long-term dangers. Many cytotoxic drugs react directly with cellular DNA, and it is perhaps not surprising that they have been found to be mutagenic and carcinogenic in laboratory experiments. Long-term survivors of cancer, treated with these agents, have experienced excesses of acute nonlymphocytic leukaemia, non-Hodgkin's lymphomas and, possibly, other solid tumours. For a number of common solid tumours, including those of the colon and the breast, cytotoxic drugs are used in an adjuvant role. Here, the balance of risk-benefit becomes really delicate, since post-surgical survival, even without the adjuvant therapy, is already appreciable. This volume consists of the proceedings of a meeting held in Heidelberg, Federal Republic of Germany.