Chinese Clinical Oncology

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Efficacy and safety of dose-dense EC followed by P regimen in neoadjuvant chemotherapy for breast cancer:a retrospective comparison with the TEC regimen

HU Sainan,YU Qiao,HU Yiqing,YUAN Yuan,GAO Jing,ZHANG Lili.   

  1. Department of Medical Oncology, Jiangsu Provincial Cancer Hospital, Nanjing 210009, China
  • Received:2014-10-07 Revised:2014-11-08 Online:2015-04-30 Published:2015-04-30
  • Contact: ZHANG Lili

Abstract: Objective To compare the efficacy and safety of dose-dense EC followed by P regimen versus TEC regimen in neoadjuvant chemotherapy for breast cancer. Methods In a retrospective comparison, the clinical data of 64 breast cancer patients with stage Ⅱa-Ⅲc in our hospital from February 2011 to August 2012 were analyzed. According to the chemotherapy regimen,31 cases received dose-dense EC followed by P regimen for 3-8 cycles before surgery(dose-dense group), and 33 cases received TEC regimen for 2-6 cycles before surgery(TEC group). Dose-dense regimen was as follows: epirubicin(90 mg/m2, d1) plus cyclophosphamide(600 mg/m2, d1) every two weeks for four cycles followed by paclitaxel(175 mg/m2, d1) every two weeks for four cycles. TEC regimen was as follows: docetaxel(75 mg/m2, d1), epirubicin(70 mg/m2, d1) and cyclophosphamide(600 mg/m2, d1) every 21 days. Response to chemotherapy was assessed by RECIST criteria 1.1 and histopathological reaction after surgery. The toxicity was evaluated according to Common Terminology Criteria Adverse Events(CTCAE) 4.0. Results All patients were evaluable for efficacy and toxicity. The assessments of 64 patients were available. The pathologic complete response rates were 16.1% and 12.1%, and the response rates were 80.6% and 66.7% in dose-dense group and TEC group, respectively. No difference was observed on the pathologic complete response rate and response rate between both groups. The 1-, 2-year disease free survival rates were 93.5% and 86.7% in dose-dense group and 93.9% and 81.8% in TEC group, and the 1-, 2-year overall survival rates were 100.0% and 90.3% in dose-dense group and 100% and 85.8% in TEC group without significant difference(P>0.05). There were higher incidences of grade 1-2 neurotoxicity(80.6% vs. 36.4%) and muscle arthrosis ache(67.7% vs. 30.3%) but a lower incidence of grade 3-4 neutropenia(6.4% vs. 33.3%) in dose-dense group versus TEC group(P<0.05). Conclusion The efficacy of dose-dense and TEC neoadjuvant chemotherapy regimens are similar. The dose-dense regimen is well tolerated and more secure, which showed a non-significant trend toward better disease free survival and overall survival when compared with the TEC regimen. It is a preferred regimen in neoadjuvant chemotherapy.

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