A comparative study of adverse reactions of taxol and non taxol based chemotherapy regimens in breast cancer
Keywords:Breast cancer, Paclitaxel, 5-Flurouracil, Adverse reactions
Background: The incidence of breast cancer is increasing in India. A combination of medicines is typically used to treat breast cancer. All the medications used in treatment are associated with various side effects. So this study is done to estimate and compare the adverse reactions of taxol and non-taxol based chemotherapy regimens in breast cancer patients attending Tirunelveli Medical College Hospital.
Methods: The study was conducted in the oncology ward at TVMCH for a period of 60 days from August 2nd October 2nd 2014. Patients with unilateral or bilateral carcinoma breast with or without metastasis, receiving chemotherapy were included. Medication details such as the type of regimen, dose, and duration of regimen and relevant data of lab investigations were collected. 30 patients who fulfilled study criteria were included, out of which 16 were assigned FAC (5flurouracil, adriamycin, cyclophosphamide) regimen and 14 were assigned PAC (paclitaxel, adriamycin, cyclophosphamide) regimen.
Results: The incidence of adverse reactions like myelodepression resulting in Neutropenia (64.28%), Anaemia (57%) and Thrombocytopaenia (21%) was comparatively higher with PAC regimens than FAC regimen. Nausea (75%) and vomiting (43%) was found to be higher with FAC regimen despite anti-emetic use. No serious adverse reactions occurred in either regimens.
Conclusions: The adverse reaction profile of FAC regimen was found to be favourable than PAC therapy though not statistically significant, with no references to efficacy and potency of these regimens in the treatment of breast cancer patients with or without metastasis.
Breast cancer statistics. Available at www.wcrf. org/int/cancer-facts-figures.
National cancer registry program. Ten year consolidated report of the hospital based cancer registries, 1984-1993, an assessment of the burden and care of cancer patients. New Delhi: Indian Council of Medical Research; 2001.
Dear RF, McGeechan K, Jenkins MC, Barratt A, Tattersall MH, Wilcken N. Combination versus sequential single agent chemotherapy for metastatic breast cancer. Cochrane Database Syst Rev. 201318;12:CD008792.
Henderson IC, Berry DA, Demetri GD, Cirrincione CT, Goldstein LJ, Martino S, et al. Improved outcomes from adding sequential paclitaxel but not from escalating doxorubicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer. Journal of Clinical Oncology. 2003;21(6):976-83.
Jassem J, Pieńkowski T, Płuzańska A, Jelic S, Gorbunova V, Mrsic-Krmpotic Z, et al. Doxorubicin and paclitaxel versus fluorouracil, doxorubicin, and cyclophosphamide as first-line therapy for women with metastatic breast cancer: final results of a randomized phase III multicenter trial. Central and Eastern Europe and Israel Pacitaxel Breast Cancer Study Group. J Clin Oncol. 2001;19(6):1707-15.
Martin M, Villar A, Sole-Calvo A, Gonzalez R, Massuti B, Lizon J, et al Doxorubicin in combination with fluorouracil and cyclophosphamide (i.v. FAC regimen, day 1, 21) versus methotrexate in combination with fluorouracil and cyclophosphamide (i.v. CMF regimen, day 1, 21) as adjuvant chemotherapy for operable breast cancer: a study by the GEICAM group. Ann Oncol. 2003;14(6):833-42.
Martín M, Lluch A, Seguí MA, Ruiz A, Ramos M, Adrover E, et al. Toxicity and health-related quality of life in breast cancer patients receiving adjuvant docetaxel, doxorubicin, cyclophosphamide (TAC) or 5-fluorouracil, doxorubicin and cyclophosphamide (FAC): impact of adding primary prophylactic granulocyte-colony stimulating factor to the TAC regimen. Ann Oncol. 2006;17(8):1205-12.