ADJUVANT CHEMOTHERAPY WITH THE 4AC–4D REGIMEN FOR STAGE II–IIIA BREAST CANCER AT HANOI ONCOLOGY HOSPITAL

Objective: To describe clinical and paraclinical characteristics and to evaluate adjuvant 4AC–4D (doxorubicin–cyclophosphamide followed by docetaxel) in stage II–IIIA breast cancer at Hanoi Oncology Hospital. Subjects and methods: A retrospective descriptive study included 67 patients enrolled from June 2019 to June 2021 and followed until June 2026. Disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan–Meier and compared with the log-rank test. Toxicities were graded using CTCAE v5.0. Results: The 40–49-year group accounted for 40.3%. Stages IIA, IIB and IIIA comprised 53.7%, 28.4% and 17.9%, respectively. All 67 patients completed eight cycles; 59 (88.0%) received 90–100% of the planned dose and 8 (12.0%) received 85–90%. DFS rates at 12, 24, 36, 48 and 60 months were 100%, 97.0%, 95.5%, 88.1% and 88.1%. OS at 48 and 60 months was 97.0%. Five-year DFS was associated with nodal status (p = 0.021) and stage (p = 0.027). Five-year OS was lower in pN2, stage IIIA, grade III, invasive lobular carcinoma and HER2-positive disease (p < 0.05), based on only two deaths sharing the same phenotype, so independent prognostic effects cannot be inferred. Neutropenia during AC occurred in 41.8% of patients (grade 3–4: 17.9%); no thrombocytopenia was recorded. Other toxicities, such as vomiting and stomatitis, occurred infrequently and were primarily grade 1–2. Conclusion: In this selected cohort of 67 eligible patients, adjuvant 4AC–4D yielded 5-year DFS of 88.1% and 5-year OS of 97.0%, with mainly grade 1–2, manageable toxicity.