Comparative Analysis On Clinical Efficacy Of TE And TEC Neoadjuvant Chemotherapy Of Breast Cancer

Objective: In this retrospective study,by comparing clinical efficacy and side effects of TE and TEC neoadjuvant chemotherapy, the relationship between different molecular classification and efficiency of neoadjuvant chemotherapy,indirectly exploreing the correlation between molecular subtypes of breast cancer and the efficiency of neoadjuvant chemotherapy. Hoping to guide the further selection of drugs for neoadjuvant chemotherapy and individualized treatment.Methods: 106 female breast cancer patients of II-III tumor stage were enrolled in this study from January 2008 to December 2011 at breast cancer center of the Third Affiliated Hospital of Kunming Medical University (China). All patients were pathologically confirmed as breast cancer and had Immunohistochemistry. Patients were divided into two different groups: TE group and TEC group, including 61 with TEC regimen and 45 with TE regimen.Pathology and clinical information was collected by telephone and outpatient follow-up. All patients received three-six cycles of neoadjuvant chemotherapy before surgery,and completed the prescribed treatment.RECIST criteria was used to evaluate the clinical efficacy, Miller Payne(MP) system was used to evaluate the pathological efficacy.According to WHO treatment response evaluation criteria, clinical efficiency,pathological complete response (pCR)and side effect were compared in two different neoadjuvant chemotherapy. Moreover, the relationship between molecular classification of breast cancer and neoadjuvant chemotherapy was discussed by SPSS version 21.0 software package (SPSS Company,Chicago, IL),the relationship between different cycles of chemotherapy with OS, and the relationship between different cycles of chemotherapy with DFS was discussed by COX risk regression model.Results: The pathological complete response (pCR) rate and clinical effitiency rate in TE group(n=45) are 17.8% and 68.9% respectively, higher than 14.8% and 65.6% in TEC group (n=61), but the difference was not statistically significant (P=0.675,0.720). The breast-conserving rate were 6.7% in TE group and 3.3% in TEC group,and the difference was not significant (P=0.416). The common side effects including granulocytopenia and liver function damage showed no significant difference between two groups (P=0.272, 0.123).But 26(57.8%%) patients had IV arrest of bone marrow in TE group ,23(37.7%) patients had IV arrest of bone marrow in TEC group. By using chi-square text, the rate of arrest of IV bone marrow had statistical difference among two groups(P=0.040).Five-year overall survival in TE group was 86.7% and 83.6% in TEC group with no significant difference(P=0.352).Patients’ age,menopausal status, the age of menarche cycle,the clinical stages,the number of chemotherapy cycles between different chemotherapy regimens were not statisfically significant.Clinical effective rate and pathologic complete response in luminal A subtype group are 47.4% and 0%, in luminal B subtype group are 64% and 10%, in the HER-2 overexpression group are 50% and 25%, in the TNBC subtype group are 87.90% and 33.3%, had statistical difference among four groups(P=0.014,0.004). The pathological complete response rate and clinical effitiency rate in TNBC group are 33.3% and 87.9% respectively, higher than 8.2% and 58.9% in non-TNBC group,the difference was statistically significant (P=0.020, 0.030).Conclusion:1. There is no difference on clinical efficacy,pCR,breast-conserving rate,OS,DFS among TE group and TEC group.2. Clinical effective rate and pathologic complete response in luminal A subtype group ,luminal B subtype group , HER2 overexpression group and TNBC subtype group are statistically significant. The pathological complete response rate and clinical effitiency rate in TNBC group and non-TNBC group are statistically significant.3. The common side effects including granulocytopenia and liver function damage showed no significant difference between two groups.But patients had IV arrest of bone marrow in TE group is higher than in TEC group.Therefore,combined with the clinical efficacy and chemotherapy side effects,TEC regimen has a good prospect in neoadjuvant chemotherapy forbreast cancer patients.