Oncology Health Centres and the Institute of Rehabilitation, University of Hull, Kingston upon Hull, East Riding of Yorkshire HU3 2PG, UK.
BMC Cancer. 2011 May 18;11:179. doi: 10.1186/1471-2407-11-179.
Weekly docetaxel has occasionally been used in the neoadjuvant to downstage breast cancer to reduce toxicity and possibly enhance quality of life. However, no studies have compared the standard three weekly regimen to the weekly regimen in terms of quality of life. The primary aim of our study was to compare the effects on QoL of weekly versus 3-weekly sequential neoadjuvant docetaxel. Secondary aims were to determine the clinical and pathological responses, incidence of Breast Conserving Surgery (BCS), Disease Free Survival (DFS) and Overall Survival (OS).
Eighty-nine patients receiving four cycles of doxorubicin and cyclophosphamide were randomised to receive twelve cycles of weekly docetaxel (33 mg/m2) or four cycles of 3-weekly docetaxel (100 mg/m2). The Functional Assessment of Cancer Therapy-Breast and psychosocial questionnaires were completed.
At a median follow-up of 71.5 months, there was no difference in the Trial Outcome Index scores between treatment groups. During weekly docetaxel, patients experienced less constipation, nail problems, neuropathy, tiredness, distress, depressed mood, and unhappiness. There were no differences in overall clinical response (93% vs. 90%), pathological complete response (20% vs. 27%), and breast-conserving surgery (BCS) rates (49% vs. 42%). Disease-free survival and overall survival were similar between treatment groups.
Weekly docetaxel is well-tolerated and has less distressing side-effects, without compromising therapeutic responses, Breast Conserving Surgery (BCS) or survival outcomes in the neoadjuvant setting.
ISRCTN: ISRCTN09184069.
每周紫杉醇偶尔用于新辅助治疗以降期乳腺癌，以降低毒性并可能提高生活质量。然而，尚无研究比较标准三周方案与每周方案在生活质量方面的差异。我们研究的主要目的是比较每周与 3 周序贯新辅助多西紫杉醇对 QoL 的影响。次要目的是确定临床和病理反应、保乳手术（BCS）的发生率、无病生存率（DFS）和总生存率（OS）。
89 例接受 4 周期多柔比星和环磷酰胺治疗的患者被随机分为 12 周期每周多西紫杉醇（33mg/m2）或 4 周期 3 周多西紫杉醇（100mg/m2）治疗。完成了癌症治疗功能评估-乳房和心理社会问卷。
中位随访 71.5 个月时，两组治疗的试验结局指数评分无差异。在每周多西紫杉醇治疗期间，患者的便秘、指甲问题、周围神经病变、疲劳、苦恼、抑郁情绪和不快乐发生率较低。总临床反应（93% vs. 90%）、病理完全缓解率（20% vs. 27%）和保乳手术（BCS）率（49% vs. 42%）无差异。两组间无病生存率和总生存率相似。
每周多西紫杉醇耐受性良好，且副作用不那么令人痛苦，不会影响新辅助治疗中的治疗反应、保乳手术（BCS）或生存结果。
ISRCTN: ISRCTN09184069。
