Comparative study of the toxicity of 5-fluorouracil-adriamycin-cyclophosphamide versus adriamycin-cyclophosphamide followed by paclitaxel in carcinoma breast

Context: When cure is possible treatment should be undertaken despite life-threatening toxicities. Fluorouracil-Adriamycin-Cyclophosphamide (FAC) and Adriamycin-Cyclophosphamide (AC-P) are two popular regimens used in the treatment of carcinoma breast and the data regarding the toxicity profile of the AC-P regimen is scarce in the South Indian population. Aims: To study the severity of different types of toxicities seen in patients on FAC and AC-P regimens, to grade the toxicity according to the World Health Organization (WHO) toxicity grading, and to compare the same. Settings and Design: A prospective observational study, with 50 patients in each regimen, was conducted in the Department of Radiotherapy between February 2007 and July 2008. Materials and Methods: The high risk patients received the AC-P regimen and the rest received the FAC regimen. The toxicities developed were graded according to the WHO guidelines. Statistical Analysis Used: The data was analyzed using the chi square test in SPSS 16. Results: Anemia, hyperpigmentation, stomatitis, and diarrhea were significantly high (P < 0.05) in patients receiving the FAC regimen, whereas, leukopenia, myalgia, arthralgia and peripheral neuropathy were significantly high (P <0.05) in patients receiving the AC-P regimen. The Karnofsky performance status was higher in patients receiving the AC-P regimen. Conclusions: Although both the regimens had different toxicity profiles the quality of life was better for patients on the AC-P regimen.