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- Title
Neoadjuvant chemotherapy with Docetaxel, Epirubicin and Cyclophosfamide in breast cancer.
- Authors
Stănculeanu, Dana Lucia; Bunghez, Raluca; Dascălu, Daniela; Chivu, Ştefania; Zob, Daniela Luminiţa
- Abstract
Purpose. To establish the efficacy of neoadjuvant (NA) Docetaxel (DOC) with anthracycline-based therapy and to determine the toxicity of NA DOC associated with Epirubicin and Cyclophoasfamide in patients with breast cancer. Patients and methods. Patients with breast cancer treated between January 2013 and December 2013 were taken into account for this study. There were included into the study 48 patients with breast cancer locally advanced, stages IIB, IIIA, IIIB, IIIC, treated in the Department of Medical Oncology I - IOB. None of the patients included were male. There were administered 6 cycles of TEC (Docetaxel 75 mg/m2 day 1, Epirubicin 75 mg/m2 day 1, Cyclophosphamide 500 mg/m2 day 1 at 21 days). Clinical tumor response was assessed at cycle 4. After 6 cycles patients who became operable went through surgical intervention. There were included patients regardless of immunohistochemistry tets - taking into accont that Trastuzumab was not reimbursed for neoadjuvant setting at that time. Results. 48 patients were enrolled. All patients completed 6 cycles of TEC treatment. At 6 series, 33 patients had surgical interventions. The remaining 15 patients in the study group were as follows: 4 patients - stable disease, 6 patients - partial remission (RECIST> 30%) but have not converted to operability, 4 patients - progressive disease (even after 4 series only one patient had progressive disease), 3 of the patients with stationary disease have had subsequent progression, 1 patient refused surgical intervention. GM-CSF were administered prophylactic; it was done the prophylaxis of mucositis. Adverse reactions more commonly observed were: hematologic toxicity (neutropeniae, anemiae, and trombocitopeniae), hepatic toxicity, digestive toxicity - more frequent of grade 1 or 2, less frequent of grade 3-4. After 24 months, 25 from 48 patients developed local recurrence or distant metastases. Conclusion. Neoadjuvant therapy type TEC (Docetaxel, Epirubicin, Ciclofosfamid) resulted in substantial improvement in responses to DOC. TEC is a series of chemotherapy relatively well tolerated with RR superior to other neoadjuvant chemotherapy regimes - according to literature, in locally advanced breast cancer cases, such as the study by Kuerer HM, Newman Smith TL et al. “Clinical course of breast cancer patients with pathologic complete axillary lymph node primary tumor and response to doxorubicin based neoadjuvant chemotherapy”, J Clin Oncol 1999; 17; 460-469, which showed a pathologic complete response at 20% of the ganglionic cases. Patients with Her 2 positive disease received adjuvant Trastuzumab; neoadjuvant administration of Trastuzumab was not reimbursed, HR positive disease received adjuvant hormonal treatments. Adjuvant radiotherapy was administered to patients according to international guidelines.
- Subjects
BREAST cancer treatment; DOCETAXEL; ADJUVANT treatment of cancer
- Publication
Oncolog-Hematolog, 2016, Issue 34, p40
- ISSN
2066-8716
- Publication type
Article