The Tolerability of in the Adjuvant Treatment of Breast Cancer Comprising Sequential Anthracycline and Taxane Treatment: Single Center Experience

OBJECTIVE: We studied the side effects associated with the adjuvant therapy combinations containing anthracycline-taxane which is the most frequently used recently in the breast cancer. Our goal is to demonstrate these side effects affecting patient quality of life and treatment success and to emphasize the importance of patient awareness.
METHODS: In the study, the files of one hundred patients with diagnosis of breast cancer were investigated retrospectively.
RESULTS: Sixty of the patients (60%) were premenopausal and 40 of them (40%) were postmenopausal (40%). One (%1) patient was stage I, 52 (52%) patients were stage II, 47 (47%) patients were stage III. While 31 of the patients received intensive therapy [paclitaxel (n=26, 80.7%), docetaxel (n=5,19.3%)], 69 of them received 3 weekly therapy [paclitaxel (n=10, 14.4%), docetaxel (n=59, 85.6%)]. Neuropathy, neutropenia and nail changes were found to be more frequent (32.3%, p<0,05; 67.7%, p<0.05; 22.6%, p<0.05 respectively) with the dose dense regimens and febrile neutropenia was observed more often with the 3-weekly regimens. There was no significant differences in terms of anemia, thrombocytopenia, hapatotoxicity and cardiotoxicity between two groups. Neuropathy, cardiotoxicity and nail changes were detected in all patients paclitaxel group and a significant difference was found between the group receiving docetaxel (p<0,05). The difference was not significant in terms of hepatotoxicity among patients receiving docetaxel and paclitaxel.
CONCLUSION: Febrile neutropenia was more frequent in the three-weekly treatment group and neuropathy was more frequent in the dose dense group. Neuropathy was more frequent with paclitaxel receiving patients. Moreover, it was demonstrated that the nail changes seen with docetaxel in other studies can be also seen with paclitaxel when dose intensity is increased.

Meme Kanserinde Adjuvan Tedavide Ardýþýk Antrasiklin ve Taksan Ýçeren Tedavilerin Tolerabilitesi: Tek Merkez Deneyimi

AMAÇ: Bu çalýþmada adjuvan kemoterapi olarak ardýþýk antrasiklin ve taksan içeren kombinasyonlarý alan meme kanserli hastalarda geliþen yan etkileri inceledik. Amacýmýz hasta yaþam kalitesini ve tedavi baþarýsýný etkileyen bu yan etkilerin ortaya konmasý ve hasta bilgilendirmesinin öneminin vurgulanmasýdýr.
YÖNTEMLER: Çalýþmamýzda tek merkezde takipli opere meme kanserli 100 hastanýn dosyalarý retrospektif olarak incelendi.
BULGULAR: Altmýþý (%60) premenopozal 100 hastanýn ortanca yaþý 47,6 (aralýk; 20-74) idi. Bir (%1) hasta evre I, 52 (%52) hasta evre II, 47 (%47) hasta evre III idi. Hastalarýn 31’i doz yoðun tedavi (DYT) [paklitaksel (n=26, %80.7), dosetaksel (n=5, %19.3)], 69’u 3 haftalýk tedavi [paklitaksel (n=10, %14.4), dosetaksel (n=59, %85.6)] almýþtý. DYT rejimleri ile daha sýk nöropati (%32.3, p<0,05), nötropeni (%67.7, p<0.05) ve týrnak deðiþikliði (%22.6, p<0.05) olduðu izlenirken 3 haftalýk tedavi ile daha sýk febril nötropeni izlendi. Anemi, trombositopeni, hepatotoksisite ve kardiyotoksisite geliþimi açýsýndan iki grup arasýnda anlamlý fark saptanmadý. Nöropati, kardiyotoksisite ve týrnak deðiþikliði geliþen hastalarýn tümü paklitaksel alan gruptaydý ve dosetaksel alan grupla arasýnda anlamlý fark saptandý (p<0,05). Hepatotoksisite geliþimi dosetaksel ve paklitaksel alan hastalar arasýnda karþýlaþtýrýldýðýnda da anlamlý fark saptanmadý.
SONUÇ: Sonuç olarak standart tedavi ile daha sýk febril nötropeni, doz yoðun rejimlerle nöropati ve paklitaksel kullanýlan rejimler ile nöropatinin daha sýk olduðu gözlendi. Ayrýca dosetaksel ile daha fazla görülen týrnak deðiþikliklerinin doz yoðunluðu arttýrýldýðýnda paklitakselle de görülebileceði gösterildi.