Abstract

The risk of treatment-related death (TRD) and febrile neutropaenia (FN) with adjuvant taxane- based chemotherapy for early breast cancer is unknown in Malaysia despite its widespread usage in recent years. This study aims to determine these rates in patients treated in University Malaya Medical Centre (UMMC). Patients who were treated with adjuvant taxane-based chemotherapy for early breast cancer stages I, II or III from 2007-2011 in UMMC were identified from our UMMC Breast Cancer Registry. The TRD and FN rates were then determined retrospectively from medical records. TRD was defined as death occurring during or within 30 days of completing chemotherapy as a consequence of the chemotherapy treatment. FN was defined as an oral temperature >38.5°C or two consecutive readings of >38.0°C for 2 hours and an absolute neutrophil count <0.5x109/L, or expected to fall below 0.5x109/L. A total of 622 patients received adjuvant chemotherapy during this period. Of these patients 209 (33.6%) received taxane-based chemotherapy. 4 taxane-based regimens were used namely the FEC-D, TC, TAC and AC-PCX regimens. The commonest regimen employed was the FEC-D regimen accounting for 79.9% of the patients. The FN rate was 10% and there was no TRD. Adjuvant taxane-based chemotherapy in UMMC for early breast cancer has a FN rate of 10%. Primary prophylactic G-CSF should be considered for patients with any additional risk factor for FN.

Highlights

  • Taxane-based adjuvant chemotherapy has come into the forefront of the armamentarium of chemotherapy available for breast cancer

  • The risk of treatment-related death (TRD) and febrile neutropaenia (FN) with adjuvant taxanebased chemotherapy for early breast cancer is unknown in Malaysia despite its widespread usage in recent years

  • A study in University Malaya Medical Centre (UMMC) on adjuvant chemotherapy for breast cancer based on 1,317 patients treated from 2000-2007 revealed a TRD rate of 0.1% but the majority of patients were treated with non-taxane based chemotherapy and the FN rate was not reported (Phua et al, 2012)

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Summary

Introduction

Taxane-based adjuvant chemotherapy has come into the forefront of the armamentarium of chemotherapy available for breast cancer. Conclusion: Adjuvant taxane-based chemotherapy in UMMC for early breast cancer has a FN rate of 10%. A study in University Malaya Medical Centre (UMMC) on adjuvant chemotherapy for breast cancer based on 1,317 patients treated from 2000-2007 revealed a TRD rate of 0.1% but the majority of patients were treated with non-taxane based chemotherapy and the FN rate was not reported (Phua et al, 2012).

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