Bajpai Jyoti, Susan Deepa, Patil Vijay, Nair Reena, Ghosh Jaya, Badwe R A, Gupta Sudeep
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Department of Medical Oncology, Tata Medical Center, Kolkata, West Bengal, India.
Indian J Med Paediatr Oncol. 2017 Jan-Mar;38(1):18-21. doi: 10.4103/0971-5851.203498.
Docetaxel, Doxorubicin, Cyclophosphamide (TAC) is an intensive chemotherapy regimen; however, being highly myelosuppressive, its usage is limited in developing countries and hence merits exploration for feasibility and efficacy.
This was a retrospective audit of medical records of breast cancer patients receiving TAC chemotherapy) from 2004 to 2008. Demographic details, toxicity, and outcome analysis were carried out.
A total of 133 patients (126 in [neo] adjuvant and 7 in metastatic setting) received TAC chemotherapy. The median age was 45 (21-67) years; 31% had coexisting diabetes and 12% hypertension. The delivered dose intensity was 94%. Discontinuation rate was 21/133 (15.8%) and the most common reason was hematological toxicity. There were 43 (32%) cases of febrile neutropenia and 2 (1.5%) Grade III thrombocytopenia with 3 (2%) toxic deaths. Grade III gastrointestinal toxicity (diarrhea) occurred in 35 (26%) and cardiac toxicity (congestive cardiac failure) in 2 (1.5%) patients. On univariate analysis, none of the variables (baseline serum albumin, hemoglobin, disease stage, or age) was found significant for chemotoxicity. At a median follow-up of 27 months (0.13-71.30 months), the estimated median disease-free survival (DFS) was 52 months in locally advanced group; however, the early breast cancer cohort has not reached to median DFS.
TAC is an effective regimen but has significant toxicity despite the use of primary prophylactic Granulocyte Colony-Stimulating-Factor (G-GSF), including a small possibility of death. It can be considered "practically feasible" regimen in the adjuvant setting in carefully selected, fit patients.
多西他赛、阿霉素、环磷酰胺（TAC）是一种强化化疗方案；然而，由于其具有高度骨髓抑制作用，在发展中国家的应用受到限制，因此有必要探讨其可行性和疗效。
这是一项对2004年至2008年接受TAC化疗的乳腺癌患者病历的回顾性审计。进行了人口统计学细节、毒性和结果分析。
共有133例患者（126例为新辅助治疗，7例为转移患者）接受了TAC化疗。中位年龄为45（21 - 67）岁；31%的患者合并糖尿病，12%的患者合并高血压。给药剂量强度为94%。停药率为21/133（15.8%），最常见的原因是血液学毒性。有43例（32%）发热性中性粒细胞减少症病例，2例（1.5%）III级血小板减少症病例，3例（2%）毒性死亡。35例（26%）患者出现III级胃肠道毒性（腹泻），2例（1.5%）患者出现心脏毒性（充血性心力衰竭）。单因素分析显示，没有一个变量（基线血清白蛋白、血红蛋白、疾病分期或年龄）对化学毒性有显著影响。中位随访27个月（0.13 - 71.30个月），局部晚期组的估计无病生存期（DFS）中位数为52个月；然而，早期乳腺癌队列尚未达到DFS中位数。
TAC是一种有效的方案，但尽管使用了一级预防性粒细胞集落刺激因子（G-GSF），仍有显著毒性，包括小概率死亡。在精心挑选的合适患者的辅助治疗中，它可被认为是“实际可行”的方案。
