ObjectiveTo observe the short-term clinical efficacy and adverse effects of paclitaxel plus pirarubicin(THP) or epirubicin(EPI) in the neoadjuvant chemotherapy of locally advanced breast cancer (LABC).MethodsForty patients with newly diagnosed LABC were enrolled and were randomly assigned to two neoadjuvant chemotherapy groups(n=20):PT group received THP plus paclitaxel,and PE group received EPI plus paclitaxel.The tumor size,the pathological response,and the adverse reactions were observed on a weekly basis.ResultsAll the patients received six courses of chemotherapy.Thirty-nine of the patients received 2-4 cycles of neoadjuvant chemotherapy before they received operation; the remaining course of treatment was carried out after surgery.One patient received operation 6 weeks after neoadjuvant chemotherapy.The pathological complete response (pCR),clinical complete response (cCR) and partial response (cPR) in PT group were 10.0%,20.0% and 75.0%,respectively,and in PE group were 5.0%,30.0% and 70.0%,respectively.There was no significant difference in the total response rates (RR) between the two groups.Cardiac toxicity and leukopenia in the two groups were grade Ⅰ-Ⅱduring the chemotherapy. The incidence of grade Ⅲ gastrointestinal reaction (nausea and vomiting) was 45.0% in the PT group and 90.0% in the PE group (P<0.05).ConclusionNeoadjuvant chemotherapy with paclitaxel plus THP or EPI has satisfactory short-term clinical efficacy and adverse effects for LABC.The rate of radical surgical resection after chemotherapy is high.The gastrointestinal adverse reaction in the PT group is significantly lower than that in PE group.Cardiac toxicity and leukopenia are weak and bone marrow suppression is slight; PT regimen is improved compared with PE group.