PROSPECTIVE STUDY TO COMPARE CLINICAL, PATHOLOGICAL RESPONSE AND ACUTE TOXICITIES IN PACLITAXEL, DOXORUBICIN AND CYCLOPHOSPHAMIDE (PAC) REGIME VERSUS 5-FLUOROURACIL, DOXORUBICIN AND CYCLOPHOSPHAMIDE (FAC) REGIME AS NEO-ADJUVANT CHEMOTHERAPY IN PATIENTS WITH LOCALLY ADVANCED BREAST CANCER.

Abstract

Background: Treatment outcome and prognosis of patients with locally advanced breast cancer is poor due to higher rate of relapse despite of advanced treatment protocol. Neo-adjuvant chemotherapy helps to down stage the large size tumor and also arrests micro-metastasis in the earliest. Pathological complete response after neo-adjuvant chemotherapy showed better long term survival. The aim of our study was to compare clinical and pathological response and acute toxicities in Paclitaxel, doxorubicin and cyclophosphamide (PAC) regime versus Fluorouracil, doxorubicin and cyclophosphamide (FAC) regime as neo-adjuvant chemotherapy in patients with locally advanced breast cancer. Materials And Methods: Locally advanced Invasive ductal carcinoma of breast of female patients were included in our study. All patients received median 4 cycles of neo-adjuvant chemotherapy. 20 patients in Control group received FAC regimen: Injection 5-Fluorouracil 500mg/m2, Doxorubicin 50mg/m2, Cyclophosphamide 500mm/m2 in D1. 20 patients in Study group received PAC regimen: Injection Paclitaxel 175mg/m2, doxorubicin 50mg/m2, Cyclophosphamide 500mg/m2 in D1. Results: Complete clinical response was 10% in control group (FAC regime) and 30% in study group (PAC regime). Complete pathological response was more in PAC regime group (25%) compare to FAC regime group (10%). In our study grade 1 and 2 toxicities developed which were manageable but there was no grade ¾ toxicities. Conclusion: PAC regime showed higher rate of complete clinical and pathological response with acceptable acute toxicities compare to FAC regime in locally advanced breast cancer patients.