Clinical Prognosis Analysis Of Adjuvant Chemotherapy With FFC And AC-T Regimen In The 96 Cases Of Triple-negative Breast Cancer Patients

Background and objective:The incidence of breast cancer is increasing year by year.Breast cancer,the most common malignant tumor in women,seriously threaten the life and health of women.Triple-negative breast cancer(TNBC),a kind of molecular classification of breast cancer,was defined as a lack of the expressions of estrogen receptor,progesterone receptor and human epidermal growth factor receptor-2,accounting for 15%-20%,insensitive to endocrine therapy,lacking of effective molecular targeted therapies,for which the treatment effect is poor,so systemic chemotherapy is the main treatment.For the selection of adjuvant chemotherapy regimes about TNBC,the anthracyclines and/or taxanes-based chemotherapy drugs is the first choice for the TNBC adjuvant chemotherapy in domestic and foreign at present.The purpose of this study was to compare the efficacy of FEC and AC-T regimen in the adjuvant chemotherapy of TNBC,and to analyze and discuss the clinical and pathological factors that affect the survival of the patients.Methods:A retrospective analysis has been conducted on the 96 cases of TNBC patients using FEC and AC-T regimen as adjuvant chemotherapy from January 2005 to December 2010 in the Second Affiliated Hospital of Dalian Medical University,median follow-up was 78 months.SPSS17.0 statistical software analysis was applied to compare whether two groups of clinical and pathological data distribution was balanced through the single factor analysis,and comparing the effects of two different chemotherapy regimens on recurrence,distant metastasis,death and the incidence of side effects,and finding out the clinical and pathological factors affecting the prognosis of the two groups;analyzing and finding the independent factors influencing the prognosis of different chemotherapy regimens through COX regression model;comparing the effects of two kinds of programs on survival through Kaplan-Meier survival function,andanalyzing the clinical pathological factors in order to find out the determinant that influence the survival of the patients.Results:96 cases of TNBC patients,including 45 cases of FEC group and 51 cases of AC-T group,were given FEC and AC-T adjuvant chemotherapy:the relapse rate was68% vs 32%,P=0.014,the local recurrence rate was 80% vs 20%,P=0.027,the distant metastasis rates was 69.6% vs 30.4%,P=0.012;the mortality rate was 71.4% vs 28.6%,P=0.011,respectively.Distant metastasis is the only factor that affects the DFS and OS of the FEC and AC-T program.The 3-year DFS of the FEC and AC-T groups were 73.3%vs 90.2%,P=0.035;the 5-year OS were 73.3% vs 90.2%,P=0.031,respectively.According to the clinical and pathological factors stratification analysis,the results show: for patients without radiotherapy,the disease free survival rate and overall survival rate of the AC-T program were higher than the FEC program,P<0.05,there was statistically significant difference;Regardless of age,menstrual status,lymph node status histological grade and whether radiotherapy,the disease-free survival and overall survival rate of the AC-T scheme were higher than the FEC scheme,but there were no statistically significant difference.Compared with the toxic effects of chemotherapy,the incidence of the 3-4 peripheral sensory neuropathy about the AC-T regimen was higher than the FEC program,P<0.05,there was statistically significant difference.Conclusions:1.Compared with FEC regimen,the AC-T regimen reduced the relapse rate and mortality rate;2.Compared with FEC scheme,the AC-T scheme significantly improved 3-year DFS and 5-year OS;3.Regardless of age,menstrual status,lymph node status histological grade and whether radiotherapy,the 3-year DFS and 5-year OS of the AC-T scheme were higher than FEC scheme;4.the incidence of the 3-4 peripheral sensory neuropathy about the AC-T regimen was higher than the FEC program.