Abstract:

Objective

To compare the efficacy and adverse reaction of the two neoadjuvant chemotherapy regimens on the basis of docetaxel and epirubisin with or without cyclophosphamide(TEC/TE) for breast cancer patients.

Methods

The clinicopathological data of totally 139 patients with stage Ⅱ-Ⅲbreast invasive ductal cancer treated in our hospital from January 2012 to April 2014 were retrospectively analyzed. All patients received four cycles of neoadjuvant chemotherapy, including 68 with TEC regimen (docetaxel 75 mg/m²+epirubicin 60 mg/m² + cyclophosphamide 500 mg/m²) and 71 with TE (docetaxel 75 mg/m²+ epirubicin 60 mg/m²). RECIST criteria were used to evaluate the clinical efficacy, and the patients with complete response (CR) and partial response (PR) were considered as clinically effective cases. MillerPayne criteria were used to evaluate the pathological efficacy, and the patients in stage Ⅴ+Ⅳ+Ⅲwere considered as pathologically effective cases). Moreover, the adverse reactions including nausea, vomiting, granulocytopenia and cardiac toxicity were also compared between two groups. Rank data were compared using non-parametric test, count data using χ² test.

Results

The pathological complete response (pCR) rate and CR rate in TEC group were 13.85%(9/68) and 10.29%(7/68) respectively, higher than 11.27%(8/71) and 5.63%(4/71) in TE group,but the difference was not statistically significant (Z=-1.804, -1.336;P=0.071,0.181).The pathologically effective rate was 78.46%(51/65,3 cases were lost) in TEC group,significantly higher than 61.97%(44/71) in TE group (χ² =4.382,P=0.036), but there was no significant difference in clinically effective rate between both groups [72.06% (49/68) vs 61.97% (44/71),χ² =1.596, P=0.206]. The breast-conserving rates were 5.88%(4/68) in TEC group and 8.45%(6/71) in TE group, and the difference was not significant (χ² = 0.066, P = 0.797). The common side effects including nausea/vomiting,granulocytopenia and cardiac toxicity showed no significant difference between two groups(Z = -1.670,-0.667, -1.326;P=0.095, 0.505, 0.185).

Conclusions

Compared with TE regimen, the patients who receive TEC regimen for neoadjuvant chemotherapy are more prone to pathological response without increasing the adverse reactions. TEC regimen has a good prospect in neoadjuvant chemotherapy for breast cancer patients.

Key words: Breast neoplasms, Chemotherapy,neoadjuvant, Epirubicin, Antharcyclines, Docetaxel