PURPOSE Asthenia, myalgia, arthralgia, mucositis, abdominal pain, diarrhea, and neutropenia are adverse reactions commonly reported by women undergoing chemotherapy. Traditional approaches do not take into account the effect that chemotherapeutic changes and variable interactions can cause in adverse reactions. We aimed to identify the impact of the change of a chemotherapy protocol within the same treatment in profiles associated with adverse reactions. METHODS A total of 166 women admitted to the Brazilian National Institute of Cancer (INCA) were followed. Polymorphisms, clinical variables, and FAC-D protocols (3 cycles of cyclophosphamide, 5-fluorouracil, and doxorubicin followed by 3 cycles of docetaxel) composed the set of independent variables analyzed. Reaction levels were recorded at the end of each chemotherapy cycle via interviews. Marginal models were fitted. RESULTS The results of marginal models for non-hematological reactions revealed that the docetaxel phase was associated with increased reaction levels compared with the FAC phase. In addition, the set of factors associated with the reactions changed in each protocol. The post-menopausal status was related to high levels of asthenia in docetaxel protocol whereas CYP2B6 polymorphism (rs3745274) was related to high levels in FAC protocol. Regarding the docetaxel phase, high levels of abdominal pain and mucositis were related to CBR3 gene (rs8133052) polymorphism and diabetes respectively. CONCLUSION The results suggest the need for monitoring non-hematological reactions during the docetaxel phase of FAC-D treatment. The factors related to more severe reactions depend on the chemotherapy protocol used.

中文翻译：

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方案变化对与乳腺癌化疗不良反应过程相关的个体因素的影响。

目的 乏力、肌痛、关节痛、粘膜炎、腹痛、腹泻和中性粒细胞减少是接受化疗的女性常见的不良反应。传统方法没有考虑化疗变化和可变相互作用在不良反应中可能引起的影响。我们旨在确定在与不良反应相关的概况中，在相同治疗中改变化疗方案的影响。方法 对巴西国家癌症研究所 (INCA) 的 166 名女性进行了随访。多态性、临床变量和 FAC-D 方案（环磷酰胺、5-氟尿嘧啶和多柔比星的 3 个周期，然后是多西紫杉醇的 3 个周期）构成了分析的一组自变量。在每个化疗周期结束时通过访谈记录反应水平。拟合了边际模型。结果 非血液学反应的边缘模型结果显示，与 FAC 期相比，多西他赛期与反应水平增加有关。此外，与反应相关的一组因素在每个协议中都发生了变化。绝经后状态与多西他赛方案中的高水平虚弱有关，而 CYP2B6 多态性 (rs3745274) 与 FAC 方案中的高水平有关。关于多西他赛期，高水平的腹痛和粘膜炎分别与CBR3基因（rs8133052）多态性和糖尿病有关。结论结果表明需要在 FAC-D 治疗的多西他赛阶段监测非血液学反应。与更严重反应相关的因素取决于所使用的化疗方案。