Background. Adding taxanes to anthracycline-based adjuvant chemotherapy has shown significant improvement particularly in node-positive patients, but optimal dose and schedule remain undetermined. Objectives. This study aimed to assess the feasibility of dose-dense epirubicin and cyclophosphamide followed by docetaxel in node-positive breast cancer. Methods. All Patients first received 4 cycles of epirubicin (100？mg/m2) and cyclophosphamide (600？mg/m2) at 2-week interval then followed by docetaxel (100？mg/m2) at 2-week interval for 4 cycles, with daily Pegfilgrastim (G-CSF) that was administered in all patients on days 3–10 after each cycle of epirubicin and cyclophosphamide infusion. Results. Fifty-eight patients with axillary lymph node-positive breast cancer were enrolled in the study, of whom 42 (72.4%) completed the regimen. There were two toxicity-related deaths, one patient due to grade 4 febrile neutropenia and the other due to congestive heart failure. Grade 3/4 neutropenia and febrile neutropenia were 13.8% and 5.1%. The most common grade 3/4 nonhematological complications were as follows: skin-nail disorders (48.3%), hand-foot syndrome (34.4%), paresthesia (38%), arthralgia (27.5%), and paresis (24.1%). Conclusions. Dose-dense epirubicin and cyclophosphamide followed by docetaxel with G-CSF support are not feasible, and it is not recommended for further investigation. 1. Introduction Adjuvant chemotherapy substantially reduces the risk of recurrence and death among women with breast cancer [1, 2]. Anthracyclines and taxanes are mainstays in treating women with axillary node-positive breast cancer, and anthracycline-containing regimens have been shown to confer higher response rates and longer overall survival [3]. Large adjuvant taxane trials were designed to test whether there was a benefit to taxanes after, or combined with, anthracycline-containing regimens [4–6]. Taxanes given sequentially or concurrently with anthracyclines have resulted in a significant improvement in disease-free and overall survival particularly in node-positive disease [4–7]. The semisynthetic taxoid docetaxel (Taxotere) is probably the most active single agent in breast cancer, and results in advanced disease supported the development of trials including both paclitaxel and docetaxel, in combination or in sequence with anthracyclines, in the adjuvant setting [8]. Clinical evidence suggested that docetaxel was a more effective taxane than paclitaxel [9]. Another study demonstrated that concurrent administration of docetaxel with doxorubicin and cyclophosphamide was
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