Abstract
In the last decade, the incidence of mortality caused by malignant disease has risen. Cancer related deaths are more frequent than those caused by infections or accidents, exceeded only by heart and vascular diseases. In most cases, it is not the primary tumor that kills patients, but its metastatic spread: metastases have a fatal outcome more than 90% of cases (1). By the time metastases have occurred, cure is rarely obtained through surgical procedures. Local radiotherapy to distant metastases is also rarely successful in the treatment of disseminated malignancies. Most patients with metastatic disease need a palliative systemic treatment, which means cytotoxic cancer chemotherapy. Its objective is to destroy cancer cells. Systemic chemotherapy has become standard in the last decades for most disseminated malignancies (1).