The CTCAE scale v4.0 was used to grade the adverse effects (except febrile neutropenia) in the first cycle of TPF chemotherapy, and the incidences of grade 3 or higher febrile neutropenia, neutropenia, anemia, thrombocytopenia, diarrhea, hyponatremia, hypokalemia, hyperkalemia, as well as increased ALT and creatinine levels were observed. Here, GPT is linked to anemia.