tbuckley/cabot-search huggingface dataset:
Systemic immune-inflammation index to predict survival in patients with metastatic urothelial carcinoma treated with second-line vinflunine.
Authors: Patrik Palacka, Jana Katolicka, Tana Albertova, Katarina Rejlekova, Jana Obertova, Matej Hrncar, Michal Chovanec, Jan Slopovsky, Michal Mego
Journal: Journal of Clinical Oncology (2020)

e17019 Background: Based on our previous study, the systemic immune-inflammation index (SII) is a prognostic factor in patients with metastatic urothelial cancer (MUC) treated with platinum-based first-line chemotherapy. The objective of this retrospective analysis was to explore prognostic value of the SII at baseline of second-line chemotherapy with vinflunine in MUC population. Methods: We evaluated 70 consecutive MUC (53 bladder, 21 upper tract) patients (54 men) treated with second-line chemotherapy with vinflunine at four oncological departments since 2010. ECOG performance status (PS) ≤ 1 had 44 patients (pts.), haemoglobin &lt; 10 g/dL was present in 25 pts. and liver involvement in 18 pts. SII was based on platelets (P), neutrophils (N) and lymphocytes (L) counts defined as PxN/L. This study population was dichotomized by median into low SII and high SII groups. Progression-free survival (PFS), overall survival (OS) and their 95% CI were estimated by Kaplan-Meier method and compared with logrank test. Results: At median follow-up of 9.0 months (1-29 months), 68 pts. experienced disease progression and 62 died. Pts. with low SII at baseline had significantly better PFS and OS opposite to those with high SII (HR = 0.61, 95% CI 0.37-1.00, p = 0.0318 for PFS, HR = 0.60, 95% CI 0.36-1.00, p = 0.0312 for OS, respectively). In addition to the prognostic factors by Bellmunt (ECOG PS ≥ 1, liver involvement, haemoglobin &lt; 10 g/dL), we identified peritoneal metastases as a factor associated with significantly worse survival (HR = 0.28, 95% CI 0.11-0.72, p &lt; 0.00001 for PFS, HR = 0.30, 95% CI 0.12-0.75, p &lt; 0.00001 for OS, respectively). Conclusions: The SII at baseline of treatment with second-line vinflunine represents a prognostic factor for pts. with MUC. Based on SII, pts. could be stratified into clinical trials in future. MUC pts. with high SII might be candidates for a different treatment approach. Key Words: Metastatic Urothelial Carcinoma. Systemic Immune-Inflammation Index. Vinflunine. Progression-Free Survival. Overall Survival.
IL-6 influences PD-L1 expression in monocytes and macrophages by effecting protein tyrosine phosphatase receptor type O expression in-human breast cancer.
Authors: Lin Chen, Jinhai Tang
Journal: Journal of Clinical Oncology (2020)

e15570 Background: We have previously discovered a relationship between the low expression of protein tyrosine phosphatase, receptor type O (PTPRO) in tumor-infiltrating T cells and immunosuppression. The aim of the present study was to investigate the relationship between decreased PTPRO and increased programmed death ligand 1 (PD-L1) in both the peripheral monocytes and tumor-infiltrating macrophages of human breast cancer (BC). Methods: The expression and correlation of all the indices were explored in monocytes and tumor infiltrating macrophages within both human and mice BC. The mechanic regulations were studied by using both in vitro and in vivo studies. Results: We found a significant decrease in PTPRO in BC peripheral monocytes that was associated with increased PD-L1 expression in peripheral monocytes and tumor-associated macrophages (TAMs) in BC. Monocyte PD-L1 and PTPRO therefore could serve as valuable prognostic indicators for post-surgery patients with BC and were associated with increased T cell exhaustion (Tim3+ T cells). A depletion of PTPRO promoted PD-L1 secretion in both monocytes and macrophages through the JAK2/STAT1 and JAK2/STAT3/c-MYC pathways. Increased IL-6 expression was associated with activation of JAK2/STAT3/c-MYC and with decreased PTPRO expression through the STAT3/c-MYC/miR-25-3p axis. Monocytes and TAMs showed significantly increased miR-25-3p expression, which could target the 3' untranslated region of PTPRO. The miR-25-3p expression positively correlated with serum IL-6 levels, but inversely correlated with PTPRO in BC monocytes. IL-6/STAT3/c-MYC activation enhanced in vitro miR-25-3p transcription and decreased PTPRO, while further promoting PD-L1 secretion. Adoptive cell transfer of c-MYC/miR-25-3p–modified monocytes promoted tumor growth by downregulating PTPRO and causing a PD-L1–induced immunosuppression in breast tumor model. Conclusions: Increased serum IL-6 downregulated PTPRO expression in BC monocytes and macrophages by activating STAT3/c-MYC/miR-25-3p and by further enhancing PD-L1 expression through JAK2/STAT1 and JAK2/STAT3/c-MYC signaling.
以肝外症状为首发表现的原发性肝癌51例
Authors: 郑世华, 罗和生, 周薇
Journal: BMJ (2005)

回顾性分析我院近5年来51例以肝外症状为首发表现的原发性肝癌患者的临床资料.首诊确诊35例(68.6%);首发症状分别为腹泻23例,发热11例,非肝区疼痛6例,低血糖5例,急腹症4例,其他2例.病史中多具有乙型肝炎、肝硬化、血吸虫病、饮酒史等危险因素;B超、CT及甲胎蛋白确诊特异性较高。
Teaching clinic for training of general practitioners in suburban of a Shanghai community
Authors: Xiaoqing Gu, Jie Gu, Meijuan Yuan, Haiying Chen, Shanzhu Zhu, Xingqian Xie
Journal: BMJ (2020)

In order to improve the quality of clinical teaching, Xidu Community Health Service Center of Shanghai Fengxian District established a teaching clinic for training of general practitioners in 2015. The clinic served as a suburban teaching station of Department of General Practice of Zhongshan Hospital, a tertiary university hospital. This article introduces the implementation methods, achievements, practical experiences and work prospects of the clinic. The issues of system evaluation and the generalization of this teaching model for training of general practitioners are also discussed in the article.


Key words: 
Community health center; General practice; Outpatient clinics teaching
脑卒中后的社区二级预防与康复治疗
Authors: 于健君, 胡永善, 范文可, 姜从玉
Journal: BMJ (2005)

脑卒中具有高死亡率、高复发率以及高致残率等特点,是严重影响人类生活质量及生命的疾病.虽然目前脑卒中的死亡率较前减少,但是这些经过急诊科、神经内科、神经外科治疗的脑卒中患者,常遗留各种后遗症,给个人造成痛苦,给家庭和社会造成沉重的负担。
A five-year follow-up study on diabetic retinopathy with intensive glucose control in outpatients with type 2 diabetes
Authors: Shu-ping Zhang, Han-jing Fu, Shen-yuan Yuan
Journal: BMJ (2010)

Objective To observe effects of long-term intensive glucose control therapy on diabetic retinopathy in outpatients with type 2 diabetes mellitus (72DM) . Methods Forty-nine patients with T2DM, aged 58 to 70 years with illness course length of 0. 6 to 12.0 years, were randomly assigned to groups receiving either intensive (24 patients) or standard glucose control (25 patients) . They were all under management with hypoglycemic treatment in the outpatient department of Beijing Tongren Hospital for five years during 2002 to 2007. Serum level of glycosylated hemoglobin Ale ( HbA1c) were measured for the patients in intensive-therapy group every three months targeting at it controlled below 6. 5% with any drugsneeded. For the patients in standard glucose control group aged 60 years or over, with history of myocardial infarction, but without other complications, serum level of HbA 1 c was measured every a half year and should be controlled under 7.0%. Their visual acuity, lens, vitreous body and fundus oculi were examined after dilatation of the pupil by ophthalmologists to identify any new diabetic retinopathy ( DR) , including micro-aneurysm, fundus hemorrhage, edema of the macula lutea, or diabetic associated blindness. Results Serum level of HbAlc had been significantly lower in intensive glucose control group [ (6. 3±0. 6 ) % ] than that in standard glucose control one [ ( 7. 1±2. 0) % ] since the second year of therapy (P < 0. 05), which could be maintained in the next four years of therapy. No new case of fundus hemorrhage or diabetic associated blindness could be found in intensive glucose control group during the five-year period of therapy.Number of new episodes of lowering in visual acuity ( 15 cases), occurrence of micro-aneurysm (five cases), edema of the macula lutea (one case), as well as those who needed retinal laser photocoagulation (four cases) , were significantly less in intensive glucose control group than that in standard glucose control one (25, 10, three and 23 cases, respectively) during five-year follow-up (P<0. 05). Conclusions Long-term intensive glucose control in patients with T2DM can significantly reduce new occurrence of diabetic retinopathy in them, which is feasible in outpatient clinics.

Key words: 
Diabetes mellitus,type 2; Blood glucose; Diabetic retinopathy
Impact of performance status on response and survival among patients receiving checkpoint inhibitors for advanced solid tumors.
Authors: Mridula Krishnan, Benjamin A. Teply, Fang Yu, Robin High
Journal: Journal of Clinical Oncology (2020)

12028 Background: Clinical trials leading to the approval of immune checkpoint inhibition (ICI) have almost exclusively been performed in patients with good performance status (ECOG PS of 0-1). However, ICI remains an attractive option for patients with advanced tumors and poor performance status, considering their overall tolerability. While use of ICI in patients with poor PS (ECOG PS of 2 or greater) has been rapidly adopted, whether these patients derive the same benefits as expected in the studied populations is largely unknown. We therefore performed an institutional retrospective analysis of all patients treated with palliative single agent anti-PD1 or anti-PDL1 to determine response and survival for those with poor performance status. Methods: We retrospectively identified patients with advanced solid tumor malignancies who were treated with ICI monotherapy with palliative intent at our institution between 2015-2019. The primary objective was to compare overall survival (OS) for patients with good PS (ECOG PS 0-1) with those with poor PS (ECOG PS 2 or 3-4). The log-rank test compared the survival among patients with different ECOG PS. In addition, we used a proportional hazards model to assess association between ECOG PS and the OS with adjustment for age, gender, and smoking status. A secondary objective was to compare overall response rates (ORR) of the three ECOG PS groups which were evaluated with a binary rate model. Results: We identified 266 patients treated with ICI, 87 with NSCLC, 34 with melanoma, 33 with RCC, 24 with bladder cancer, 22 with head/neck cancer, and the rest with other histologies. 187 (70%) were ECOG PS 0-1, 62 (23%) were ECOG PS 2, and 17 (7%) were ECOG PS 3-4. 89 of these patients (33%) were still alive at time of last follow-up. Across all tumor types, patients with ECOG PS 0-1 had superior survival compared to ECOG PS 2 (median survival 12.4 months vs 4.6 months, HR 0.41, p &lt; 0.001). Median survival for ECOG PS 3-4 was lower at 2.3 months. The ORR for ECOG PS 0-1 (23%) was significantly higher to that of ECOG PS 2 (6%, p = 0.02). ORR for ECOG PS 3-4 was 12%. Conclusions: Despite the appeal of ICI for patients with advanced malignancy and poor performance status, outcomes were poor. Survival and objective response rates for patients with ECOG PS 2 and higher were significantly worse than those with ECOG PS 0-1. ICI treatment comes with cost, including potentially forgoing early hospice referral or optimal support at the end of life. Prospective trials defining the activity and role of ICI in poor PS are urgently needed.
积极开展慢性阻塞性肺疾病的教育和管理
Authors: 何权瀛
Journal: BMJ (2004)

慢性阻塞性肺疾病(COPD)给患者及家庭、社会造成沉重经济负担,成为一个重大的公共卫生问题,因此需要进行长期和规范化的防治.这个过程需要得到广大COPD患者及其家属的大力支持和密切配合.同时应当看到COPD患者到医院的诊治(包括门诊、住院治疗)时间对其一生来说只是一个短暂的片段.其生命中的大部分时间是在家庭、社会中度过的,因而我们对于COPD的防治不能只停留或局限于医院这个小天地,应当尽可能拓展到患者的家庭乃至整个社会。
Effects of telmisartan on the serum levels of homocysteine and transforming growth factor-β 1 in patients with early diabetic nephropathy
Authors: Peng Liu, De-bao Wang, Feng-mei Zhang
Journal: BMJ (2012)

Sixty patients with early diabetic nephropathy (DN) and normal blood pressure were randomly divided into telmisartan treatment and control groups.And the blood biochemical parameters,urinary albumin excretion rate (UAER),the serum levels of homocysteine (HCY) and transforming growth factor-β1 (TGF-β1) were measured at both pre- and post-treatment of 24 weeks.After treatment,the levels ofUAER,HCY [(61 ±26) vs.(98±38) mg/L,(11.70 ±2.86) vs.(14.4±2.8) μmol/L (P＜ 0.01 ) ]and homeostasis model of insulin resistance index,TGF-β1 [ ( 3.17 ± 0.66) vs.( 3.60 ± 0.87 ),(66 ± 14) vs.(77 ± 17 )U/L respectively (P ＜ 0.05 )]in the telmisartan group were significantly lower than those in the control group.It indicated that telmisartan could improve the insulin sensitivity,significantly decrease the serum levels of HCY and TGF-β1,reduce UAER and exert kidney protection effects in the patients with early DN.

Key words: 
Diabetic nephropathies ;  Cysteine
急性中毒性肝衰竭诊治二例
Authors: 陈秋霞, 韩亚轩
Journal: BMJ (2011)

例1女性,26岁,因情绪低落自服多种含有乙酰氨基酚的感冒药后腹痛,恶心呕吐3d,伴意识障碍4h,2011年2月14日门诊以“急性乙酰氨基酚中毒,急性肝衰竭”收入院.体检:血压100/60 mm Hg(1 mm Hg =0.133 kPa),浅昏迷,皮肤黏膜及巩膜黄染,颈软无抵抗,双肺未见异常,心率90次/min,律齐,未闻及杂音,腹部检查无异常,双侧巴宾斯基征阳性. 关键词：肝功能衰竭;急性
Circulating nucleosomes in hematological malignancy.
Authors: Jason Terrell, Eleonore Josseaux, Helene Latora, Guillaume Rommelaere, Natalie Hardat, Marielle Herzog, Jake Micallef, Mark Eccleston
Journal: Journal of Clinical Oncology (2020)

e20078 Background: There are over 700,000 new cases of non-Hodgkin lymphoma (NHL), acute myeloid leukaemia (AML) and acute lymphocytic leukaemia (ALL) diagnosed globally each year and approximately 415,000 deaths. The non-specific symptoms of lymphoma and leukemia often delay diagnosis. We investigated the circulating levels of intact nucleosomes containing the histone H3.1 isoform (Nu.Q-H3.1) in a variety of solid tumors, NHL, AML, ALL, and in healthy subjects. Methods: We measured levels of Nu.Q-H3.1 in plasma samples taken from 62 healthy volunteers (mean age = 45 yrs) and 329 patients diagnosed with cancer (mean age = 56 yrs), including 25 patients diagnosed with each of cancer of the bladder, bone, brain, oesophagus, cervix, skin, head &amp; neck or melanoma, 21 patients diagnosed with uterine cancer as well as with NHL (n = 25), AML (n = 25) and ALL (n = 8). The cohort included samples taken from patients at diagnosis and at relapse. Whole blood samples were collected in EDTA plasma tubes, double-centrifuged at 1500 rcf for 15 minutes within 2 hrs of blood draw, after which plasma was transferred to a cryotube and frozen immediately until analysis. Plasma samples (20µl) were analyzed in duplicate for Nu.Q-H3.1 using an ELISA method developed and validated to CLSI guidelines. Results: We observed elevated levels of Nu.Q-H3.1 in the patients diagnosed with various cancers. Only 14 of 271 patients with a solid tumor had levels &gt; 200ng/ml. In contrast the median Nu.Q-H3.1 levels observed for NHL, AML and ALL were 276, 284 and 585ng/ml respectively. The median nucleosome level in 62 healthy subjects was 40ng/ml; the highest level was 198ng/ml. The AUC for all patients diagnosed with NHL, AML or ALL (n = 54) vs healthy volunteers was 91% with a sensitivity of 74% at 95% specificity. The AUC for the subset of patients newly diagnosed with NHL, AML or ALL (n = 31) vs healthy volunteers was 92% with a sensitivity of 81% at 95% specificity. Conclusions: Elevated nucleosome levels have been reported for a number of diseases. Our early results indicate that levels of Nu.Q-H3.1 are particularly elevated in haematological malignancies and may be a useful diagnostic tool warranting further study.
Physical activity and health in Chinese children and adolescents: expert consensus statement (2020)
Authors: Peijie Chen, Dengfeng Wang, Hongbing Shen, Lijuan Yu, Qian Gao, Lijuan Mao, Fan Jiang, Yaojia Luo, Minhao Xie, Yong Zhang, Lianshi Feng, Feng Gao, Yuling Wang, Yu Liu, Chunyan Luo, George P Nassis, Peter Krustrup, Barbara E Ainsworth, Peter A Harmer, Fuzhong Li
Journal: British Journal of Sports Medicine (2020)

China is experiencing significant public health challenges related to social and demographic transitions and lifestyle transformations following unprecedented economic reforms four decades ago. Of particular public health concern is the fourfold increase in overweight and obesity rates in the nation’s youth population, coupled with the low prevalence of adolescents meeting recommended levels of physical activity. Improving the overall health of China’s more than 170 million children and adolescents has become a national priority. However, advancing nationwide health initiatives and physical activity promotion in this population has been hampered by the lack of a population-specific and culturally relevant consensus on recommendations for achieving these ends. To address this deficiency and inform policies to achieve Healthy China 2030 goals, a panel of Chinese experts, complemented by international professionals, developed this consensus statement. The consensus was achieved through an iterative process that began with a literature search from electronic databases; in-depth reviews, conducted by a steering committee, of the resulting articles; and panel group evaluations and discussions in the form of email correspondence, conference calls and written communications. Ultimately, the panel agreed on 10 major themes with strong scientific evidence that, in children and adolescents aged 6–17, participating in moderate to vigorous physical activities led to multiple positive health outcomes. Our consensus statement also (1) highlights major challenges in promoting physical activity, (2) identifies future research that addresses current knowledge gaps, and (3) provides recommendations for teachers, education experts, parents and policymakers for promoting physical activity among Chinese school-aged children and adolescents. This consensus statement aligns with international efforts to develop global physical activity guidelines to promote physical activity and health and prevent lifestyle-related diseases in children and adolescents. More importantly, it provides a foundation for developing culturally appropriate and effective physical activity interventions, health promotion strategies and policy initiatives to improve the health of Chinese children and adolescents.
Chronic diarrhea and functional gastrointestinal diseases
Authors: Yingqiang Zhong
Journal: BMJ (2018)

通过介绍慢性腹泻与功能性胃肠病及二者的关系，明确了慢性腹泻的定义，简述引起慢性腹泻的常见病因与病理生理机制，介绍了引起慢性腹泻的功能性胃肠病的常见类型和临床诊断，详细总结了这类慢性腹泻的治疗措施，并对难治性腹泻型功能性胃肠病的处理提出展望。
Treatment of cervical spondylotic radiculopathy with electroacupuncture
Authors: Hong Zhang, Li-ping He
Journal: BMJ (2010)

To evaluate the therapeutic effects of electroacupuncture in treatment of cervicalspondylotic radiculopathy (CSR). Ninety CSR patients were randomly divided into two groups with 45 ineach; in treatment group patients received electroacupuncture; in control group patients were treated withphysical therapy (ultrashort wave and hot style low frequency wave). The therapeutic effects and the changesof clinical assessment scale for cervical spondylosis (CASCS) score were observed between two groups. Aftertreatment, the overall effective rates were 93% in treatment group and 84% in control group (P>0. 05) ;however the rate of marked improvement and the CASCS score were higher in treatment group than those incontrol group (P <0. 01). Electroacupuncture has a more favorite therapeutic effect than physical therapy forCSR.

Key words: 
Electroacupuncture;  Cervical spondylosis
Acalabrutinib (Acala) versus idelalisib plus rituximab (IdR) or bendamustine plus rituximab (BR) in relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL): ASCEND final results.
Authors: Paolo Ghia, Andrzej Pluta, Malgorzata Wach, Daniel Lysak, Tomas Kozak, Martin Simkovic, Polina Kaplan, Iryna Kraychok, Arpad Illes, Javier De La Serna, Sean Dolan, Philip Campbell, Gerardo Musuraca, Abraham Jacob, Eric Joseph Avery, Jae Hoon Lee, Denise Wang, Priti Patel, Cheng Seok Quah, Wojciech Jurczak
Journal: Journal of Clinical Oncology (2020)

8015 Background: Acala is a next-generation, highly selective, covalent Bruton tyrosine kinase inhibitor approved for patients (pts) with CLL including those with R/R CLL. The efficacy and safety of acala alone vs IdR or BR were shown in R/R CLL pts in a preplanned interim analysis of ASCEND; final results are reported herein. Methods: In this randomized, multicenter, phase 3, open-label study (NCT02970318), R/R CLL pts were randomized 1:1 to receive oral (PO) acala 100 mg BID or investigator’s (INV) choice of IdR (Id: 150 mg PO BID until progression or toxicity; R: 375 x1 then 500 mg/m 2 intravenously [IV] for 8 total infusions) or BR (B: 70 mg/m 2 IV and R: 375 x1 then 500 mg/m 2 IV for 6 total cycles) until progression or toxicity. Progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and safety were assessed. Results: 310 pts (acala, n=155; IdR, n=119; BR, n=36) were enrolled (median age: 67 y; del(17p) 16%, del(11q) 27%, Rai stage 3/4 42%). At a median follow-up of 22.0 m, acala significantly prolonged INV-assessed PFS vs IdR/BR (median: not reached vs 16.8 m; hazard ratio: 0.27, P&lt;0.0001); 18-m PFS rates were 82% for acala and 48% for IdR/BR. 18-m OS rate was 88% for both treatment regimens. ORR was 80% with acala vs 84% with IdR/BR (ORR + partial response with lymphocytosis: 92% vs 88%, respectively). Common adverse events (AEs) are listed in the Table. AEs led to drug discontinuation in 16% of acala, 56% of IdR, and 17% of BR pts. AEs of interest included atrial fibrillation (acala 6%, IdR/BR 3%), major hemorrhage (all grade; acala 3%, IdR/BR 3%), grade ≥3 infections (acala 20%, IdR/BR 25%), and second primary malignancies excluding non-melanoma skin cancer (acala 5%, IdR/BR 2%). Conclusions: Final ASCEND results with additional follow-up confirm earlier findings and support the favorable efficacy and safety of acala compared with standard-of-care regimens in R/R CLL pts. Clinical trial information: NCT02970318 . [Table: see text]
非法医学期刊曝光台
Authors: 中华医学会杂志社
Journal: BMJ (2005)

2005年4月29日出版的 又一次公布了新闻出版总署、全国扫黄打非工作小组办公室宣布取缔的非法期刊名单,在被取缔的60种期刊中有医学期刊16种,加上2004年7月13日和11月19日公布的非法报刊名单中的11种医学期刊,非法医学期刊达27种。
Comparing efficacy and toxicity profile of weekly paclitaxel to dose-dense paclitaxel (every two weeks) in treatment of breast cancer: A meta-analysis and systematic review.
Authors: Usman Khan, Antonio DeRosa, Jiaqiong Xu, Tejal Amar Patel
Journal: Journal of Clinical Oncology (2020)

e12634 Background: Neoadjuvant and adjuvant chemotherapy includes anthracyclines and taxanes has been used in early stage breast cancer. Studies have demonstrated superiority of weekly and dose dense Paclitaxel when compared with every 3 week regimen. Both weekly and dose dense administration of paclitaxel is an acceptable treatment as they are thought to have similar disease free and overall survival. The two regimens have clearly different toxicity profile but not many studies have compared them against each other. We conducted this analysis to compare efficacy of both regimens in terms of pCR if used in neoadjuvant setting and compared both regimen in terms of grade 3-4 neurotoxicity. Methods: Systematic literature searches were conducted in four databases for randomized controlled trials published in English. The databases searched were: (1) MEDLINE (2) Embase, (3) The Cochrane Library, and (4) Scopus. 18 studies were included in pCR data analysis. Total of 38 studies were included in this meta-analysis for the toxicity analysis. Results: Our analysis showed no significant difference in the rate of pathological complete response between weekly paclitaxel and dose dense paclitaxel (p=0.266). Meta-analysis showed the overall estimate proportion for weekly paclitaxel causing neurotoxicity was 0.04 (95% CI: 0.02-0.06) and for the dose dense paclitaxel 0.10 (95% CI: 0.05-0.17). The test for heterogeneity between two sub-groups in toxicity analysis was p=0.042. Conclusions: Our analysis showed no significant difference in rate of pCR between two regimens however rate of grade 3-4 neurological toxicity was more in dose dense paclitaxel as compared to weekly paclitaxel. This difference in neurological toxicity with no corresponding difference in rate of pathological complete response can be an important factor in deciding the chemotherapy regimen for our patients.