Yanagihara Keiko, Yoshida Masato, Yamakawa Tamami, Kato Sena, Tamura Miki, Nagata Koji
Department of Breast Surgery and Oncology, Nippon Medical School Tama-Nagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo 206-8512, Japan.
Department of Pharmacy, Nippon Medical School Tama-Nagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo 206-8512, Japan.
Curr Oncol. 2025 Aug 6;32(8):441. doi: 10.3390/curroncol32080441.
Dose-dense chemotherapy shortens the interval between chemotherapy cycles and has shown improved outcomes in high-risk breast cancer patients. We retrospectively evaluated the efficacy and safety of dose-dense chemotherapy in 80 breast cancer patients treated at our hospital from 2020 to 2024. The regimen included epirubicin and cyclophosphamide followed by paclitaxel or docetaxel, with pegfilgrastim support. The overall treatment completion rate was 82.5%. Of the 80 patients, 55 underwent neoadjuvant chemotherapy, and the pathological complete response rate was significantly higher in triple-negative breast cancer (59.1%) compared to that in luminal-type cancer (9.1%). Common adverse events included anemia, liver dysfunction, myalgia, and peripheral neuropathy. Febrile neutropenia occurred in 8.8% of patients, with some cases linked to pegfilgrastim body pod use, particularly in individuals with low subcutaneous fat. Notably, two patients developed pneumocystis pneumonia, potentially associated with steroid administration. Despite these toxicities, most were manageable and resolved after treatment. Our findings support the efficacy of dose-dense chemotherapy, particularly in triple-negative breast cancer, while highlighting the importance of individualized supportive care and vigilance regarding hematologic and infectious complications.
剂量密集化疗缩短了化疗周期之间的间隔时间，并已在高危乳腺癌患者中显示出改善的治疗效果。我们回顾性评估了2020年至2024年在我院接受治疗的80例乳腺癌患者中剂量密集化疗的疗效和安全性。该方案包括表柔比星和环磷酰胺，随后使用紫杉醇或多西他赛，并给予培非格司亭支持。总体治疗完成率为82.5%。在这80例患者中，55例接受了新辅助化疗，三阴性乳腺癌的病理完全缓解率（59.1%）显著高于管腔型癌（9.1%）。常见的不良事件包括贫血、肝功能障碍、肌痛和周围神经病变。8.8%的患者发生了发热性中性粒细胞减少，部分病例与培非格司亭的使用有关，尤其是皮下脂肪少的个体。值得注意的是，两名患者发生了肺孢子菌肺炎，可能与类固醇给药有关。尽管存在这些毒性，但大多数情况是可控的，治疗后可缓解。我们的研究结果支持剂量密集化疗的疗效，特别是在三阴性乳腺癌中，同时强调了个体化支持治疗以及对血液学和感染性并发症保持警惕的重要性。
