Adeel Muhammad, Asif Muhammad, Faisal Muhammad Naeem, Chaudary Muhammad Hasanain, Malik Muhammad Sheraz, Khalid Muhammad
Department of Computer Science, Faculty of Science, National Textile University, Faisalabad, Punjab, Pakistan,
Faculty of Veterinary Science, Institute of Pharmacy, Physiology, and Pharmacology, University of Agriculture, Faisalabad, Punjab, Pakistan.
Cancer Manag Res. 2019 Jan 15;11:727-739. doi: 10.2147/CMAR.S180802. eCollection 2019.
This retrospective study presents a comparative analysis of the overall survival and toxicities, as side effects, of docetaxel plus cyclophosphamide (TC) and doxorubicin plus cyclophosphamide (AC). The study measured their efficacies during adjuvant chemotherapy, treating Pakistani breast cancer patients by validating the results obtained, with the published analysis of the same treatment given to US patients.
Between June 2015 and September 2017, for four chemotherapy cycles, 189 patients out of 358 received TC (75 mg/m of docetaxel, 600 mg/m of cyclophosphamide) and 169 were treated with AC (60 mg/m of doxorubicin, 600 mg/m of cyclophosphamide). On the basis of using pathological markers to assess patients, toxicities, as side effects, (due to docetaxel, doxorubicin, and cyclophosphamide) were listed in the database of this study. Common factors with respect to common terminology criteria for adverse events version 5.0 and side effects listed in MedlinePlus, NIH US database, and from the database of this study were then separated to be included in comparison for this study. Statistically, chi-squared test was used at α=0.05.
There was no statistically significant difference between the proportions of patients with vomiting, extreme tiredness, diarrhea, mild anemia, stability, and overall survival because -value >0.05. However, AC remained less toxic (-value <0.05) by 22.6%, 25.7%, 25.3%, 12.4%, 20.8%, and 16.4% compared to TC for changes in taste, muscle pain, burning hands, change in hemoglobin level, moderate anemia, and needing blood transfusion respectively, whereas TC remained less toxic by 52.9%, 32.5%, and 26.3% for dizziness, weight loss, and sores in throat and mouth, respectively.
At 27 months, TC was more toxic than AC, whereas both combinations had the same overall survival rate.
本回顾性研究对多西他赛联合环磷酰胺（TC）与阿霉素联合环磷酰胺（AC）的总生存率及作为副作用的毒性进行了比较分析。该研究在辅助化疗期间对其疗效进行了评估，通过验证所获结果来治疗巴基斯坦乳腺癌患者，并与已发表的针对美国患者的相同治疗分析结果进行对比。
2015年6月至2017年9月期间，358名患者中有189名接受了4个化疗周期的TC治疗（多西他赛75mg/m²，环磷酰胺600mg/m²），169名接受了AC治疗（阿霉素60mg/m²，环磷酰胺600mg/m²）。基于使用病理标志物对患者进行评估，本研究数据库中列出了（因多西他赛、阿霉素和环磷酰胺导致的）作为副作用的毒性。然后，根据不良事件通用术语标准第5.0版以及美国国立医学图书馆（NIH）MedlinePlus数据库和本研究数据库中列出的副作用，分离出常见因素，纳入本研究进行比较。统计学上，采用α=0.05的卡方检验。
呕吐、极度疲劳、腹泻、轻度贫血、病情稳定和总生存率的患者比例之间无统计学显著差异，因为P值>0.05。然而，与TC相比，AC在味觉改变、肌肉疼痛、手部烧灼感、血红蛋白水平变化、中度贫血和需要输血方面的毒性分别低22.6%、25.7%、25.3%、12.4%、20.8%和16.4%，而TC在头晕、体重减轻以及咽喉和口腔溃疡方面的毒性分别低52.9%、32.5%和26.3%。
在27个月时，TC的毒性比AC更大，而两种联合方案的总生存率相同。
