title: Risk of treatment related death and febrile neutropaenia with taxane-based adjuvant chemotherapy for breast cancer in a middle income country outside a clinical trial setting.
abstract: BACKGROUND
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. vince_phua@yahoo.com
authors.forename: Chee Ee
authors.initials: CE
authors.lastname: Phua
authors.forename: Anita Zarina
authors.initials: AZ
authors.lastname: Bustam
authors.forename: Mastura Md
authors.initials: MM
authors.lastname: Yusof
authors.forename: Marniza
authors.initials: M
authors.lastname: Saad
authors.forename: Cheng-Har
authors.initials: CH
authors.lastname: Yip
authors.forename: Nor Aishah
authors.initials: NA
authors.lastname: Taib
authors.forename: Char Hong
authors.initials: CH
authors.lastname: Ng
authors.forename: Yew Ching
authors.initials: YC
authors.lastname: Teh
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D016190:Carboplatin / Q000009:adverse effects; D002423:Cause of Death; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000009:adverse effects; D000077143:Docetaxel; D004317:Doxorubicin / Q000009:adverse effects; D015251:Epirubicin / Q000009:adverse effects; D005260:Female; D005334:Fever / Q000139:chemically induced; D005472:Fluorouracil / Q000009:adverse effects; D006801:Humans; D008296:Malaysia; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D017239:Paclitaxel / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D001952:Bridged-Ring Compounds; D043823:Taxoids; D000077143:Docetaxel; C080625:taxane; D015251:Epirubicin; D004317:Doxorubicin; D003520:Cyclophosphamide; D016190:Carboplatin; D017239:Paclitaxel; D005472:Fluorouracil