Table 2.
Overall grade toxicity profile, the pattern of G-CSF use, and treatment delay among breast cancer patients who received AC and AC-T chemotherapy at TASH, from January 1 to September 30, 2017 GC.
| Chemotherapy cycles | ||||||||
| Variables | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| N (%) | 146 (%) | 146 (%) | 146 (%) | 146 (%) | 100 (%) | 100 (%) | 75 (%) | 75 (%) |
|
| ||||||||
| Hematological toxicities | ||||||||
| Neutropenia | 44 (30) | 57 (39) | 57 (39) | 59 (40.4) | 18 (18) | 13 (13) | 10 (13.3) | 5 (6.8) |
| Grade 3 | 20 (13.7) | 9 (6.2) | 22 (15.1) | 23 (15.8) | 6 (6) | 1 (1) | 2 (2.7) | — |
| Grade 4 | 3 (2.1) | 6 (4.1) | 5 (3.4) | 5 (3.4) | 2 (2) | 2 (2) | — | — |
| Leukopenia | 38 (26) | 49 (34) | 52 (35.6) | 68 (46.6) | 17 (17) | 20 (20) | 8 (10.7) | 10 (13.5) |
| Grade 3 | 2 (1.4) | — | 3 (2.1) | 1 (0.7) | — | 1 (1) | 1 (1.3) | 1 (1.3) |
| Grade 4 | — | — | — | — | — | — | — | — |
| Anemia | 22 (15.1) | 24 (16) | 29 (19.9) | 31 (21.2) | 17 (17) | 13 (13) | 10 (13.3) | 9 (12.2) |
| Grade 3 | 1 (0.7) | — | 2 (1.4) | — | — | — | — | — |
| Grade 4 | — | — | — | — | — | — | — | — |
| Lymphopenia | 27 (18.5) | 29 (20) | 56 (38.3) | 46 (31.5) | 28 (28) | 21 (21) | 9 (12) | 12 (16.2) |
| Grade 3 | 1 (0.7) | — | 2 (1.4) | 2 (1.4) | 2 (2) | 2 (2) | — | — |
| Grade 4 | — | — | — | — | — | — | — | — |
| Thrombocytes ∗ | 2 (1.4) | 3 (2.1) | 2 (1.4) | 5 (3.4) | 2 (2) | 2 (2) | 1 (1.3) | 1 (1.3) |
| Grade 3 | — | — | — | — | — | — | — | — |
| Grade 4 | — | — | — | — | — | — | — | — |
|
| ||||||||
| Nonhematological toxicities | ||||||||
| AST ↑ | 12 (8.2) | 11 (7.5) | 16 (11) | 16 (11) | 11 (11) | 10 (10) | 7 (9.3) | 7 (9.5) |
| Grade 3 | — | 2 (1.4) | — | — | — | — | — | — |
| Grade 4 | — | — | — | — | — | — | — | — |
| ALT ↑ | 7 (4.8) | 4 (2.7) | 5 (3.4) | 8 (5.5) | 9 (9) | 9 (9) | 7 (9.3) | 7 (9.5) |
| Grade 3 | 2 (1.4) | — | — | — | — | 1 (1) | — | — |
| Grade 4 | — | — | — | — | — | — | — | — |
| ALP ↑ | 22 (15.1) | 19 (13) | 17 (11.6) | 17 (11.6) | 18 (18) | 18 (18) | 9 (12) | 11 (14.9) |
| Grade 3 | 2 (1.4) | — | — | 1 (0.7) | 1 (1) | 1 (1) | 1 (1.3) | 1 (1.3) |
| Grade 4 | — | — | — | — | — | — | — | — |
| Cr ↑ | 11 (7.5) | 9 (6.7) | 13 (8.9) | 8 (5.5) | 3 (3) | 5 (5) | 4 (5.3) | 2 (2.7) |
| Grade 3 | — | — | — | — | — | — | — | — |
| Grade 4 | — | — | — | — | — | — | — | — |
| Infection | 1 (0.7) | 2 (1.4) | 6 (4.1) | 0 (0) | 2 (2) | 2 (2) | 4 (5.3) | 0 (0) |
| Grade 3 | — | — | — | — | — | — | — | — |
| Grade 4 | — | — | — | — | 1 (1) | — | — | — |
| Nausea ## | 123 (84.3) | 124 (85) | 124 (84.9) | 110 (75.3) | 36 (36) | 26 (26) | 7 (9.3) | 5 (6.8) |
| Grade 3 | 31 (21.2) | 24 (16.4) | 14 (9.6) | 18 (12.3) | 1 (1) | 1 (1) | — | — |
| Vomiting | 92 (63) | 88 (60.3) | 96 (65.8) | 86 (58.9) | 24 (24) | 19 (19) | 1 (1.3) | 1 (1.3) |
| Grade 3 | 12 (8.2) | 7 (4.8) | 10 (6.8) | 14 (9.6) | — | — | — | — |
| Grade 4 | — | — | — | — | — | — | — | — |
| OM | 41 (28.1) | 53 (36.3) | 52 (35.6) | 50 (30.2) | 14 (14) | 17 (17) | 8 (10.7) | 8 (10.8) |
| Grade 3 | 5 (3.4) | 8 (5.5) | 6 (4.1) | 9 (6.2) | 2 (2) | 2 (2) | — | — |
| Grade 4 | — | — | — | — | — | — | — | — |
| Fatigue ## | 136 (93.2) | 135 (92.5) | 134 (91.8) | 125 (85.6) | 83 (83) | 79 (79) | 51 (68) | 49 (66.2) |
| Grade 3 | 3 (2.1) | 1 (0.7) | 5 (3.4) | 6 (4.1) | 3 (3) | — | 2 (2.7) | 2 (2.7) |
| PNP | 32 (21.9) | 44 (30.1) | 43 (29.5) | 51 (34.9) | 66 (66) | 67 (67) | 64 (85.3) | 63 (85.1) |
| Grade 3 | — | — | 1 (0.7) | — | 16 (16) | 15 (15) | 15 (20) | 14 (18.9) |
| Grade 4 | — | — | — | — | — | — | — | — |
|
| ||||||||
| Supportive measures given | ||||||||
| G-CSF use∗∗ | 9 (6.2) | 9 (6.2) | 17 (11.6) | 15 (10.3) | 5 (5) | 2 (2) | 2 (2.7) | 0 (0) |
| Antibiotic$ | 9 (6.2) | 9 (6.2) | 17 (11.6) | 15 (10.3) | 5 (5) | 2 (2) | 2 (2.7) | 0 (0) |
| T. Delay# | 17 (11.6) | 9 (6.2) | 31 (21.2) | 21 (14.4) | 8 (8) | 6 (6) | 3 (4) | 0 (0) |
“—” = no grade 3 or 4 toxicity reported; grade 3 and grade 4 represent a severe and life-threatening form of adverse drug reactions, respectively. ∗Thrombocytopenia. ∗∗Granulocyte colony-stimulating factor use for different grade neutropenia. $Antibiotic use was oral ciprofloxacin 500 mg twice a day for seven days. #T.delay = treatment delay due to toxicity. OM = oral mucositis; PNP = peripheral neuropathy. ##Grade 4 and above are not available for nausea and fatigue on the PRO part of NCI CTCAE (version 4.03).