ABSTRACT
OBJECTIVE: To evaluate the effects and toxicity of the neoadjuvant chemotherapy of docetaxel combined with epirubicin or pirarubicin on breast cancer, and to investigate the influencing factors of the response to neoadjuvant chemotherapy. METHODS: 160 patients with stage II/III breast cancer, all females, aged 47 (22-66), were treated with docetaxel plus epirubicin or pirarubicin with 3 weeks as a cycle. Two to six cycles of treatment were given before surgery. The clinical efficacy and toxicity of the treatment were evaluated, and the correlation between the influencing factors and the clinical parameters with treatment response was analyzed. RESULTS: The clinical response rate (RR) was 90% (144/160), the complete response (CR) rate was 26% (41/160), the partial response (PR) rate was 64% (103/160). The stable disease (SD) rate was 8% (13/160). The progress disease (PD) rate was 2% (3/160), the pathologically complete remission (pCR) rate was 7% (11/160), and the tumor-pathological complete response (tpCR) rate was 2% (1.3/160). Univariate analysis showed that the tumor size, clinical stage, triple negative phenotype might be the meaningful parameters influencing the clinical response. The patients with smaller tumor size, low stage tumor, and being triple-negative were more likely to achieve CR (P = 0.0371, 0.0013, and 0.0019 respectively). Age, histological grading, ER/PR ratio, Her-2 status did not significantly influence the early response. Multivariate analysis showed that the disease stage might be the meaningful factors for better response (P = 0.0030). The major toxic reactions of the therapy included neutropenia, alopecia, nausea, and vomiting. CONCLUSION: The combination neoadjuvant chemotherapy with docetaxel and epirubicin or pirarubicin is an effective method to treat breast cancer with tolerable toxicity. The meaningful parameter influencing the early response is clinical stage.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Neoadjuvant Therapy , Adult , Aged , Antineoplastic Agents/administration & dosage , Breast Neoplasms/pathology , Docetaxel , Doxorubicin/administration & dosage , Doxorubicin/analogs & derivatives , Epirubicin/administration & dosage , Female , Humans , Logistic Models , Middle Aged , Neoplasm Staging , Taxoids/administration & dosage , Young AdultABSTRACT
OBJECTIVE: To evaluate the clinical efficacy and toxicity of combination neoadjuvant chemotherapy with docetaxel and pharmorubicin in the treatment of locally advanced breast cancer. METHODS: From June 2005 to March 2007, 94 breast cancer patients who have been pathologically confirmed by core needle biopsy were treated with neoadjuvant chemotherapy before operation. Docetaxel 75 mg/m(2) plus pharmorubicin 80 mg/m(2) were administered as intravenous infusion on the first day of each 3-week cycle. Accepted 2 to 4 cycles of the treatment, the patients were underwent surgery after 12 to 16 days. RESULTS: The overall response rate (RR) was 80% (76/94). The complete clinical response rate (CR) was 22% (21/94). The partial response rate (PR) was 58% (55/94). The stable disease (SD) rate was 17% (16/94). The progress disease (PD) rate was 2% (2/94). The pathological complete rate (pCR) was 3% (3/94). The major toxic reactions of the therapy were neutropenia, alopecia, nausea and vomit. 76 patients (80%) suffered with grade 3 to 4 neutropenia. 4 patients suffered with grade 3 to 4 thrombocytopenia. 84 patients suffered with severe alopecia. 90 patients (95%) accepted supportive treatment of G-CSF. Septicemia and death were not occurred in this study. CONCLUSION: The combination neoadjuvant chemotherapy with docetaxel and pharmorubicin is an effective method to treat breast cancer and the toxicities are tolerable.
