Archives of Gynecology and Obstetrics

, Volume 284, Issue 1, pp 215–220 | Cite as

Quality of life and toxicity in breast cancer patients using adjuvant TAC (docetaxel, doxorubicin, cyclophosphamide), in comparison with FAC (doxorubicin, cyclophosphamide, 5-fluorouracil)

  • N. HatamEmail author
  • N. Ahmadloo
  • A. Ahmad Kia Daliri
  • P. Bastani
  • M. Askarian
Gynecologic Oncology



The aim of this study was to compare two regimens of chemotherapy in patients with breast cancer, including FAC (doxorubicin, cyclophosphamide, and 5-fluorouracil) and TAC (docetaxel, doxorubicin and cyclophosphamide); and analyze the toxicity of these treatments and observe patient’s health-related quality of life.


Health-related quality of life was assessed for up to 4 months (from the beginning to the end of chemotherapy cycles), using European organization and cancer treatment quality of life questionnaire (EORTC) QLQ-C30. A group of 100 patients, with node-positive breast cancer were studied in order to compare the toxicity of adjuvant therapy TAC with FAC and the subsequent effects on the patient’s quality of life.


After a 4-month follow-up of patients, our findings showed that despite having the same mean score of QOL at the start of adjuvant chemotherapy, the QOL in TAC arm was decreased more as a result of the higher range of toxicity in TAC regimen.


In spite of increase in disease-free patients who received TAC regimen and increase their survival rate, there is significant toxicity and decrease in QOL in TAC protocol compare to FAC protocol. Using prophylactic granulocyte colony stimulating factor (G-CSF) along with increased education aimed at improving patient’s knowledge and also the provision of a supportive group involving psychiatrics and patients that have successfully experienced the same treatment may be helpful.


Quality of life Toxicity Adjuvant therapy Breast cancer 



The authors would like to thank the 100 patients who agreed to participate in this study in spite of their bad physical and emotional condition. We gratefully acknowledge all the staff in the chemotherapy ward of Namazi Hospital and Mrs. Alison Geraldine Imanieh for editorial assistance. This study was funded by Shiraz University of Medical Sciences, registered 88-4648.

Conflict of interest



  1. 1.
    Micheli A, Goeberg JW, Mugno E et al (2003) European health systems and cancer care. Ann Oncol 14:41–60CrossRefGoogle Scholar
  2. 2.
  3. 3.
    Brinton L, Lacey J, Devesa SS (2002) Epidemiology of breast cancer. In: Donegan WL, Spratt JS (eds) Cancer of the breast, vol 2, 5th edn. WB Saunders, Philadelphia, pp 111–132 Google Scholar
  4. 4.
    Mant D, Vessey MP (1991) Epidemiology of breast cancer. In: Kirby I, Copeland EM (eds) The breast: comprehensive management of benign and malignant diseases, vol 116. WB Saunders, Philadelphia, pp 363–365 Google Scholar
  5. 5.
    Hajian S, Mirzai Najm Abadi KH, Keramat A et al (1998) Systematic survey on the effects of limb relaxation and directed intellectual on pain and distress reduction because of the treatment’s side effects on women suffering from breast cancer during 1998–2007 in Farsi. Iran’s Breast Dis 1(3):32–43Google Scholar
  6. 6.
    Tirgiri B, Aghebati N, Fazwl A et al (1996) Investigating the relationship between the type of adjuvant therapy with the anxiety, depression and fatigue score in breast cancer patients in Farsi. Razi Fac Nurs Obstet Mag 6:52–59Google Scholar
  7. 7.
    Bonneterre J, Bercez C, Bonneterre M-E, Lenne X, Dervaux B (2005) Cost-effectiveness analysis of breast cancer adjuvant treatment: FEC 50 versus FEC 100 (FASG05 study). Ann Oncol 16(6):915–922PubMedCrossRefGoogle Scholar
  8. 8.
    Martin M (2006) Docetaxel doxorubicin and cyclophosphamide (the TAC regimen): an effective adjuvant treatment for operable breast cancer. Womens Health (Lond Engl) 2(4):527–37Google Scholar
  9. 9.
    Martín M, Lluch A, Seguí MA, Ruiz A, Ramos M et al (2006) Toxicity and health-related quality of life in breast cancer patients receiving adjuvant docetaxel, doxorubicin, cyclophosphamide (TAC) or 5-fluorouracil, doxorubicin and cyclophosphamide (FAC): impact of adding primary prophylactic granulocyte-colony stimulating factor to the TAC regimen. Ann Oncol 17(8):1205–1212Google Scholar
  10. 10.
    Fayers PM, Aaronson NK, Bjordal K et al (2001) On behalf of the EORTC quality of life group. EORTC QLQ-C30 scoring manual (3rd edn), EORTC, BrusselsGoogle Scholar
  11. 11.
    Montazeri A, Harirchi I, Vahdani M (1999) The European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ-C30): translation and validation study of the Iranian version. Support Care Cancer 7:400–406PubMedCrossRefGoogle Scholar
  12. 12.
    Haji Mohamadi M, Ebrahimi M, Jarvandi S et al (2000) The EORTC breast cancer specific quality of life questionnaire (EORTC–BR23): translation and validation study of the Iranian version. Qual Life Res 9(2):177–184CrossRefGoogle Scholar
  13. 13.
    Shaban M, Monjamed Z, Mehran A, Hassan Poor Dehkordi A (1383) The relationship between cancer’s characteristics and patients’ quality of life who treating with chemotherapy in Farsi. Haiat 22:79–84Google Scholar
  14. 14.
    Rom J, von Minckwitz G, Eiermann W, Sievert M, Schlehe B et al (2008) Oblimersen combined with docetaxel, adriamycin and cyclophosphamide as neo-adjuvant systemic treatment in primary breast cancer: final results of a multicentric phase I study. Ann Oncol 19:1698–1705PubMedCrossRefGoogle Scholar
  15. 15.
    Martin M, Pienkowski T, Mackey J et al (2005) Adjuvant docetaxel for node-positive breast cancer. N Engl J Med 352:2302–2313PubMedCrossRefGoogle Scholar
  16. 16.
    Boer K, Lang I, Juhos É, Pinter T et al (2003) Adjuvant therapy of breast cancer with docetaxel-containing combination (TAC)—a Hungarian experience in the BCIRG 001 trial. Pathol Oncol Res 9(3):229–238CrossRefGoogle Scholar
  17. 17.
    Martin M, Liuch A, Segul MA et al (2006) Toxicity and health related quality of life in breast cancer patients receiving adjuvant docetaxel, doxorubicin, and cyclophosphamide (TAC) or 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC). Ann Oncol 17(8):1205–1212PubMedCrossRefGoogle Scholar
  18. 18.
    Brain GC, Bachelot T, Serin D, Kirscher S, for the RAPP-01 Trial Investigators et al (2005) Life-threatening sepsis associated with adjuvant doxorubicin plus docetaxel for intermediate-risk breast cancer. JAMA 293:2367–2371PubMedCrossRefGoogle Scholar
  19. 19.
  20. 20.
    Martin M, Pienkowsk T, Mackey J, Pawlicki M et al (2005) Adjuvant docetaxel for node-positive breast cancer. N Eng J Med 352(22):2302–2313, 2346–2348 Google Scholar
  21. 21.
  22. 22.
  23. 23.
  24. 24.
  25. 25.
    Martin M, Vogal C, Crown J, Mackey J (2005) Life-threatening complications from doxorubicin–docetaxel chemotherapy for breast cancer. JAMA 294(17):2166Google Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • N. Hatam
    • 1
  • N. Ahmadloo
    • 2
  • A. Ahmad Kia Daliri
    • 3
  • P. Bastani
    • 4
  • M. Askarian
    • 5
  1. 1.School of Management and Medical Information SciencesShiraz University of Medical ScienceShirazIran
  2. 2.Department of Radiation Oncology, Namazi HospitalShiraz University of Medical ScienceShirazIran
  3. 3.Division of the Health Economics, Center for Primary Health Care ResearchLund UniversityLundSweden
  4. 4.Shiraz University of Medical Science (SUMS)ShirazIran
  5. 5.Community Medicine DepartmentShiraz University of Medical Science (SUMS)ShirazIran

Personalised recommendations