ABSTRACT
OBJECTIVE:To provide reference for clinical rational drug use in advanced breast cancer patients with grade Ⅳmyelosupression induced by chemotherapy. METHODS:108 advanced breast cancer patients with grade Ⅳ myelosupression in-duced by chemotherapy in our hospital from July 2014 to June 2015 were retrospectively analyzed on the characteristics of myelosu-pression and the reasonability of chemotherapy reguneb and adjuvant drug for myelosupression. RESULTS:The incidence of gradeⅣ myelosupression induced by chemotherapy in advanced breast cancer patients was 8.3%,chiefly manifesting as grade Ⅳ neutro-penia(94.4%). The chemotherapy regimens which induced grade Ⅳ myelosupression were mainly docetaxel+epirubicin,docetaxel, vinorelbine+lobaplatin;irrational chemotherapy plan mainly shows irrational pretreatment of chemotherapy drug (32 cases, 91.4%);irrational therapy of myelosupression mainly manifested as rophylactic use of antimicrobials without indication,unsuitable choice of antibiotics(29 cases for each,36.2% for each). CONCLUSIONS:The use of drugs used in advanced breast cancer pa-tients with grade Ⅳ myelosupression induced by chemotherapy is basically rational,yet it is far from perfect in pretreatment of che-motherapy drug and therapy for gradeⅣmyelosupression,which should be further improved.
ABSTRACT
AIM: The aim of this study is to assess the efficacy and toxicity of 5‑flurouracil (5‑FU) and cisplatin (PF) versus taxane and cisplatin (TP) as induction chemotherapy in locally advanced head and neck squamous cell cancer. MATERIALS AND METHODS: There were 50 patients in each arm, matched for age, performance state, site and stage of disease. PF arm (cisplatin ‑ 100 mg/m2 D1, 5‑FU ‑ 1000 mg/m2 D1‑D5) TP arm (docetaxel ‑ 75 mg/m2 or paclitaxel ‑ 175 mg/m2 on D1, cisplatin 75 mg/m2 on D2), received once in 3 weeks for 3 cycles. Patients without progressive disease underwent either surgery or chemoradiation. The primary end point was overall response rate (ORR) and secondary endpoint was toxicity. RESULTS: In a total of 100 patients in our study, 44 in PF and 47 in TP arm were evaluable. ORR was 86.6% in PF arm and 82.9% in TP arm (P = 0.71).There were more Grade 3 or 4 events of neutropenia, mucositis (P ≤ 0.05) and myelosuppression diarrhea, febrile neutropenia (P ≥ 0.05) in PF arm compared with TP arm. Post‑chemotherapy hospital admissions due to toxicity were more frequent in PF arm (38.6% vs. 19%), dropout rate due to toxicity (9% vs. 0%) and deaths (6.8% vs. 2.1%) were more common in PF arm compared with TP arm. CONCLUSION: TP induction chemotherapy better tolerated than PF, which has similar efficacy, further multicenter randomized controlled studies; involving a large sample size is needed to confirm our data.