WHICH IS BETTER WEEKLY OR 3-WEEKLY PACLITAXEL? - IN COMBINATION CHEMOTHERAPY USING PACLITAXEL AND DOXORUBICIN IN METASTATIC CARCINOMA BREAST

Dr. P. Senthil Kumar; Dr. Premkumar Devdoss

Volume : IX, Issue : I, January - 2020

WHICH IS BETTER WEEKLY OR 3-WEEKLY PACLITAXEL? - IN COMBINATION CHEMOTHERAPY USING PACLITAXEL AND DOXORUBICIN IN METASTATIC CARCINOMA BREAST

Dr. P. Senthil Kumar, Dr. Premkumar Devdoss

Abstract :

Introduction Metastatic east cancer (MBC) is known as an incurable disease with a median 5-year survival rate around 23.8–30%.Each physician maintains a hierarchy of goals for the treatment of patients � prolongation of survival, palliation of symptoms, minimization of toxicity, and rarely, in a small fraction of patients, the potential for cure. Aim The aim of this study was to compare the efficacy and toxicity of weekly paclitaxel, and 3-weekly paclitaxel in combination with doxorubicin in metastatic carcinoma east. Methods This study was prospective randomised controlled trial. 30 patients were randomised to weekly paclitaxel as well as to 3-weekly paclitaxel in combination with doxorubicin after inclusion and exclusion criteria. Combination chemotherapy in carcinoma east Arm A - Paclitaxel 75mg/m2 weekly (Day 1, 8 , 15)and doxorubicin 50mg/m2 3-weekly (Day 1). Arm B – Paclitaxel 175mg/m2 3-weekly (Day1) and doxorubicin 50mg/m2 3-weekly (Day 1). The treatment was planned for 2 cycles only. Appropriate premedication and supportive therapy was given as needed. The response to chemotherapy will be assessed at end of 3 weeks after 2nd cycle. Further treatment in non-responders was individualised as per standard guidelines. Statistical data were analysed using SPSS. Results. The overall response rate of combination chemotherapy in this study was 40%. Arm A (43.3%) had better response rate than Arm B (36.7%).The quality of life was poor in 18.3% of the total study population. In Arm A 33.3% had good quality of life, which was better than Arm B (23.3%). Quality of life was moderate in 50% in Arm A and 56.7% in Arm B. In Arm A and Arm B, 16.7% and 20% had poor quality of life respectively. The incidence of toxicity such as neuropathy, neutropenia, vomiting, anorexia, anemia and thrombocytopenia was found to less in Arm A than Arm B. The incidence of fatigue, alopecia, nausea and nail changes was found to be less in Arm B than Arm A. Conculsion Weekly paclitaxel had better response rate than 3-weekly paclitaxel in combination with doxorubicin in metastatic carcinoma east. The quality of life was better in weekly paclitaxel than 3-weekly paclitaxel.