title: Reduction of toxicity by reversing the order of infusion of docetaxel and cyclophosphamide.
abstract: BACKGROUND
  This retrospective study aimed to determine whether adverse events are more common in docetaxel followed by cyclophosphamide (TC) as compared to the reverse infusion order (rTC).
  
  
  METHODS
  A retrospective analysis was undertaken at a single institution for 92 consecutive cases treated with TC or rTC for stage I-III breast cancer in a neoadjuvant/adjuvant setting between December 2006 and June 2011. TC was administered during the first 2.5 years and rTC in the latter 2 years.
  
  
  RESULTS
  Among the 92 cases, 50 were in the TC arm and 42 in the rTC arm. Fatigue (72.0 vs. 23.8%), edema (48.0 vs. 16.7%), peripheral neuropathy (66.0 vs. 14.3%), myalgia (48.0 vs. 9.5%) and stomatitis (48.0 vs. 16.7%) occurred significantly more often in cases receiving TC compared to rTC, respectively.
  
  
  CONCLUSIONS
  Nonhematological toxicities are less common in cases receiving rTC in comparison to those receiving TC.
authors.affiliation: Department of Breast and Endocrine Surgery, Toranomon Hospital, Tokyo, Japan.
authors.forename: Marie
authors.initials: M
authors.lastname: Hanaoka
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Kawabata
authors.forename: Tsuguo
authors.initials: T
authors.lastname: Iwatani
authors.forename: Toshimi
authors.initials: T
authors.lastname: Takano
authors.forename: Daishu
authors.initials: D
authors.lastname: Miura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage*; D000077143:Docetaxel; D005260:Female; D005500:Follow-Up Studies; D006402:Hematologic Diseases / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D003520:Cyclophosphamide