Feasibility and toxicity of EC?T dose?dense adjuvant chemotherapy: A real world study in Chinese early?stage breast cancer patients with high recurrence risk
10.3760/cma.j.issn.0253?3766.2019.05.009
- VernacularTitle:高复发风险早期乳腺癌患者行表阿霉素联合环磷酰胺序贯紫杉醇剂量密集辅助化疗的耐受性分析
- Author:
Jiani WANG
1
;
Yuxin MU
;
Qing LI
;
Ying FAN
;
Jiayu WANG
;
Fei MA
;
Yang LUO
;
Peng YUAN
;
Shanshan CHEN
;
Qiao LI
;
Ruigang CAI
;
Pin ZHANG
;
Binghe XU
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院 北京协和医学院肿瘤医院内科100021
- Keywords:
Breast neoplasms;
Dose?dense adjuvant chemotherapy;
Adverse effect;
Epirubicin
- From:
Chinese Journal of Oncology
2019;41(5):368-372
- CountryChina
- Language:Chinese
-
Abstract:
Objective We aimed to examine the feasibility and toxicity of EC?T dose?dense regimen and to demonstrate the suitable dose of epirubicin in a Chinese early?stage breast cancer population with high recurrence risk. Methods 370 patients with early?stage breast cancer at high risk of recurrence were treated with EC?T dose?dense adjuvant chemotherapy and prophylactic administration of recombinant human granulocyte stimulating factor (G?CSF). The incidence of delayed chemotherapy, drug reduction and adverse reactions were retrospectively analyzed. Results 370 patients completed the planned eight cycles of chemotherapy, 50 patients experienced chemotherapy delay, and 90 had chemotherapy dose reductions. Overall, 61.1% of the patients experienced grade 3 or 4 hematology toxicities, 4.1% of the patients experienced grade 3 gastrointestinal toxicity, 16.3% experienced grade 3 or 4 liver malfunction, and 1.9%experienced grade 3 alopecia. In the multivariate analysis, pretreatment epirubicin levels were associated with comprehensive and hematology toxicity risk ( OR＝1.268, P＝0.046; OR＝1.244, P＝0.036). With G?CSF support, the probability of grade 3?4 dose limiting toxicity, i.e. neutropenia, abnormal liver function, and gastrointestinal adverse effects did not increase as the epirubicin dose level increased ( P＞0.05). However, there were no statistically significant associations between epirubicin grade and treatment delay (P＝0.814) or dose reduction (P＝0.282). Conclusions EC?T dose?dense chemotherapy shows tolerable toxicity. High dose level is not a limiting factor for this regimen.With G?CSF support, epirubicin 85?90 mg／m2 is appropriate tolerance dose for Chinese early breast cancer patients with high recurrence risk.
