6 Cycles Of Epirubicin Plus Docetaxel Versus 4 Cycles Of Epirubicin And Cyclophosphamide Followed By 4 Cycles Of Docetaxel In Adjuvant Therapy Of Breast Cancer

Objective:This study compared 6 cycles of epirubicin and docetaxel(ED) with a sequential regimen of 4 cylces epirubicin and cyclophosphamide followed by 4 cycles of docetaxel as adjuvant therapy in feasibility, toxicity and therapeutic effect.Method:We conducted a follow-up to gather treatment and survival information of patients who received either ED(EPI/DTX 70/75 mg/m2,3 weeks interval for 6 cycles) or EC-D(4 cycles EPI/CTX 70/600mg/m2 followed by 4 cycles of DTX 75mg/m2 at 3 weeks interval) from Jan,2009 to Jan,2014 in Qilu Hospital of Shandong University. The basic characteristics, pathological and immunohistochemistry results were collected from the database of our hospital.Results:A total of 374 patients were enrolled in this study, of which 250 patients received ED regimen and 124 patients received EC-D regimen. The median follow-up time was 38.6 months (13 months to 6 years).Basic characteristics were well balanced between treatment groups. The completion status of the ED and EC-D regimen was not significantly different (90% for ED vs 94.4% for EC-D,P=0.174).There was no significant difference in disease-free survival or overall survival between these 2 regimens (log-rank PDFS=0.919,log-rank Pos=0.069).The incidence of neutropenia and proportion of patients who received G-CSF injection were not significant higher with ED (neutropenia,81.2% for ED vs 78.9% for EC-D P=0.660;G-CSF utilization rate,76.9% for ED vs 75.2% for EC-D,P=0.850). The incidence of severe gastrointestinal reactions was higher with EC-D (42.0% for EC-D vs 29.2%for ED, P=0.058).Conclusion:The compliance and the toxicities were similar between the EC-D and ED regimen. The short-term efficacy was not significant different of the two regimens, whereas final results of efficacy comparison await longer follow-up of more patients.