Abstract
Methods This study included patients from two prospective studies conducted in our institute from April 2007 to March 2009. Ninety-one women with axillary lymph node-positive breast cancer who had received four cycles of dose-dense epirubicin and cyclophosphamide were treated with either weekly paclitaxel (80 mg/m2) for 12 doses or biweekly docetaxel (75 mg/m2) for four cycles. Results After a median follow-up of 88 and 109 months, 11 (23.4%) and 10 (22.7%) patients had experienced disease recurrence (p = 0.16), while 10 (21.3%) and 5 (11.4%) patients had died in the paclitaxel and docetaxel arm, respectively (p = 0.56). No significant difference could be seen in 5-year DFS or OS among groups (HR: 0.58; 95% CI: 0.19–1.81, p = 0.35; HR: 0.58; 95% CI: 0.19–1.81, p = 0.35, respectively). Conclusion In conclusion, both evaluated adjuvant chemotherapy regimens have comparable effectiveness regarding DFS and OS.
Highlights
Breast cancer is the most common cancer in women worldwide, and it has been estimated that more than 35 percent of these patients present with axillary node metastasis [1, 2]
Their report showed that no differences were found regarding the comparisons of taxane type, paclitaxel 175 mg/m2 given every three weeks was associated with significantly lower disease-free survival (DFS) compared with weekly paclitaxel and three weekly docetaxel (HR, 0.84; p = 0:011 and HR, 0.79; p = 0:001, respectively)
Figure 1: 5-year disease-free survival in months for paclitaxel and dose-dense docetaxel as adjuvant chemotherapy for node positive breast cancer patients
Summary
Breast cancer is the most common cancer in women worldwide, and it has been estimated that more than 35 percent of these patients present with axillary node metastasis [1, 2]. International Journal of Breast Cancer standard clinical practice in node-positive breast cancer patients is to administer a regimen of anthracyclinebased chemotherapy followed by a taxane, either docetaxel or paclitaxel [4]. The results of a meta-analysis of 13 studies on over 23,000 women with high-risk, early-stage breast cancer indicated a significant enhancement in overall survival (OS) as well as disease-free survival (DFS) regardless of ER expression, nodal involvement, type of taxane, patient’s age and menopausal status, and treatment schedule after adding taxanes to the anthracycline-based regimen [5]. A meta-analysis assessing several randomized clinical trials (RCTs), in which dose-dense versus standard-schedule chemotherapy were compared in breast cancer, reported a significant survival benefit for dosedense schedules in resected (mainly node-positive) disease [8]
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