Curr Oncol. 2009 Dec;16(6):8-12. doi: 10.3747/co.v16i6.311.
Adjuvant chemotherapy for early breast cancer improves disease-free and overall survival in pre- and postmenopausal women. The importance of maintaining relative dose intensity (RDI) is well-known; however, little information is available from routine clinical practice regarding how well dose intensity is maintained with modern chemotherapy regimens.In a retrospective review of patients undergoing chemotherapy for early breast cancer at a single institution in Canada from January 2006 to November 2007, a total of 263 patients received one of the following regimens:AC-T [doxorubicin (Adriamycin: Pharmacia, Kalamazoo, MI, U.S.A.)-cyclophosphamide, paclitaxel (Taxol: Bristol-Myers Squibb, Princeton, NJ, U.S.A.)]FEC-100 (5-fluorouracil-epirubicin-cyclophosphamide)FEC-D (5-fluorouracil-epirubicin-cyclophosphamide, docetaxel)Overall, only 14.4% of patients had a RDI less than 85%. Dose delay or reduction (or both) occurred in 46%, 37%, and 20% of patients receiving fec-100, ac-t, and fec-d respectively. Optimal RDI was delivered to 96%, 95%, and 70.7% of patients for ac-t, fec-d and fec-100 regimens respectively. Patients over 65 years of age accounted for 14% of the total cohort and were more likely to receive a suboptimal RDI than were patients younger than 65 years of age (35% vs. 6.6%).Optimal chemotherapy RDI (>85%) for early breast cancer can be achieved at an academic cancer centre. This goal is less often accomplished in elderly patients, and thus a proactive approach is required for managing toxicity in that population.
辅助化疗可改善绝经前和绝经后早期乳腺癌患者的无病生存和总生存。维持相对剂量强度（RDI）的重要性是众所周知的；然而，从常规临床实践中，有关现代化疗方案的剂量强度维持情况的信息很少。
在对加拿大一家机构 2006 年 1 月至 2007 年 11 月期间接受早期乳腺癌化疗的患者进行回顾性审查中，共有 263 名患者接受了以下方案之一：
AC-T（阿霉素[多柔比星：Pharmacia，卡拉马祖，MI，美国]-环磷酰胺，紫杉醇[紫杉醇：百时美施贵宝，普林斯顿，NJ，美国]）
FEC-100（5-氟尿嘧啶-表柔比星-环磷酰胺）
FEC-D（5-氟尿嘧啶-表柔比星-环磷酰胺，多西他赛）
总体而言，只有 14.4%的患者的 RDI 低于 85%。分别接受 fec-100、ac-t 和 fec-d 的患者中，有 46%、37%和 20%发生剂量延迟或减少（或两者兼有）。分别有 96%、95%和 70.7%的患者接受了 ac-t、fec-d 和 fec-100 方案的最佳 RDI。年龄超过 65 岁的患者占总队列的 14%，比年龄小于 65 岁的患者更有可能接受不理想的 RDI（35%比 6.6%）。
在学术癌症中心，可实现早期乳腺癌的最佳化疗 RDI（>85%）。这一目标在老年患者中较难实现，因此需要采取积极的方法来管理该人群的毒性。
