School of Management and Medical Information Sciences, Shiraz University of Medical Science, Shiraz, Iran.
Arch Gynecol Obstet. 2011 Jul;284(1):215-20. doi: 10.1007/s00404-010-1609-8. Epub 2010 Aug 26.
The aim of this study was to compare two regimens of chemotherapy in patients with breast cancer, including FAC (doxorubicin, cyclophosphamide, and 5-fluorouracil) and TAC (docetaxel, doxorubicin and cyclophosphamide); and analyze the toxicity of these treatments and observe patient's health-related quality of life.
Health-related quality of life was assessed for up to 4 months (from the beginning to the end of chemotherapy cycles), using European organization and cancer treatment quality of life questionnaire (EORTC) QLQ-C30. A group of 100 patients, with node-positive breast cancer were studied in order to compare the toxicity of adjuvant therapy TAC with FAC and the subsequent effects on the patient's quality of life.
After a 4-month follow-up of patients, our findings showed that despite having the same mean score of QOL at the start of adjuvant chemotherapy, the QOL in TAC arm was decreased more as a result of the higher range of toxicity in TAC regimen.
In spite of increase in disease-free patients who received TAC regimen and increase their survival rate, there is significant toxicity and decrease in QOL in TAC protocol compare to FAC protocol. Using prophylactic granulocyte colony stimulating factor (G-CSF) along with increased education aimed at improving patient's knowledge and also the provision of a supportive group involving psychiatrics and patients that have successfully experienced the same treatment may be helpful.
本研究旨在比较两种乳腺癌化疗方案,包括 FAC(多柔比星、环磷酰胺和 5-氟尿嘧啶)和 TAC(多西他赛、多柔比星和环磷酰胺);分析这些治疗方法的毒性,并观察患者的健康相关生活质量。
使用欧洲癌症研究与治疗组织生活质量问卷(EORTC)QLQ-C30 对健康相关生活质量进行评估,最长可达 4 个月(从化疗周期开始到结束)。对 100 例淋巴结阳性乳腺癌患者进行研究,以比较辅助治疗 TAC 与 FAC 的毒性,并观察对患者生活质量的后续影响。
在对患者进行 4 个月的随访后,我们的发现表明,尽管在辅助化疗开始时具有相同的 QOL 平均评分,但由于 TAC 方案的毒性范围更高,TAC 组的 QOL 下降更多。
尽管接受 TAC 方案的无病患者增加,生存率提高,但与 FAC 方案相比,TAC 方案存在显著的毒性和 QOL 下降。使用预防性粒细胞集落刺激因子(G-CSF),并加强对患者的教育,旨在提高患者的知识水平,同时提供一个包括精神病学专家和成功接受相同治疗的患者在内的支持小组,可能会有所帮助。