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Prospective evaluation of concurrent paclitaxel and radiation therapy after adjuvant doxorubicin and cyclophosphamide chemotherapy for Stage II or III breast cancer

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Title: Prospective evaluation of concurrent paclitaxel and radiation therapy after adjuvant doxorubicin and cyclophosphamide chemotherapy for Stage II or III breast cancer
Authors: Burstein, Harold J.1 hburstein@partners.org, Bellon, Jennifer R.2, Galper, Sharon2, Lu, Hsiao-Ming2, Kuter, Irene3, Taghian, Alphonse G.4, Wong, Julia2, Gelman, Rebecca2,5, Bunnell, Craig A.1, Parker, Leroy M.1, Garber, Judy E.1, Winer, Eric P.1, Harris, Jay R.2, Powell, Simon N.4
Source: International Journal of Radiation Oncology, Biology, Physics. Feb2006, Vol. 64 Issue 2, p496-504. 9p.
Subjects: Breast cancer, Radiotherapy, Drug therapy, Doxorubicin, Research
Abstract: Purpose: To evaluate the safety and feasibility of concurrent radiation therapy and paclitaxel-based adjuvant chemotherapy, given either weekly or every 3 weeks, after adjuvant doxorubicin and cyclophosphamide (AC). Methods and Materials: After definitive breast surgery and AC chemotherapy, 40 patients with operable Stage II or III breast cancer received protocol-based treatment with concurrent paclitaxel and radiation therapy. Paclitaxel was evaluated on 2 schedules, with treatment given either weekly × 12 weeks (60 mg/m2), or every 3 weeks × 4 cycles (135–175 mg/m2). Radiation fields and schedules were determined by the patient’s surgery and pathology. The tolerability of concurrent therapy was evaluated in cohorts of 8 patients as a phase I study. Results: Weekly paclitaxel treatment at 60 mg/m2 per week with concurrent radiation led to dose-limiting toxicity in 4 of 16 patients (25%), including 3 who developed pneumonitis (either Grade 2 [1 patient] or Grade 3 [2 patients]) requiring steroids. Efforts to eliminate this toxicity in combination with weekly paclitaxel through treatment scheduling and CT-based radiotherapy simulation were not successful. By contrast, dose-limiting toxicity was not encountered among patients receiving concurrent radiation with paclitaxel given every 3 weeks at 135–175 mg/m2. However, Grade 2 radiation pneumonitis not requiring steroid therapy was seen in 2 of 24 patients (8%) treated in such a fashion. Excessive radiation dermatitis was not observed with either paclitaxel schedule. Conclusions: Concurrent treatment with weekly paclitaxel and radiation therapy is not feasible after adjuvant AC chemotherapy for early-stage breast cancer. Concurrent treatment using a less frequent paclitaxel dosing schedule may be possible, but caution is warranted in light of the apparent possibility of pulmonary injury. [Copyright &y& Elsevier]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
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DbLabel: Engineering Source
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AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
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  Data: Prospective evaluation of concurrent paclitaxel and radiation therapy after adjuvant doxorubicin and cyclophosphamide chemotherapy for Stage II or III breast cancer
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  Data: <searchLink fieldCode="AR" term="%22Burstein%2C+Harold+J%2E%22">Burstein, Harold J.</searchLink><relatesTo>1</relatesTo><i> hburstein@partners.org</i><br /><searchLink fieldCode="AR" term="%22Bellon%2C+Jennifer+R%2E%22">Bellon, Jennifer R.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Galper%2C+Sharon%22">Galper, Sharon</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Lu%2C+Hsiao-Ming%22">Lu, Hsiao-Ming</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Kuter%2C+Irene%22">Kuter, Irene</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Taghian%2C+Alphonse+G%2E%22">Taghian, Alphonse G.</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Wong%2C+Julia%22">Wong, Julia</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Gelman%2C+Rebecca%22">Gelman, Rebecca</searchLink><relatesTo>2,5</relatesTo><br /><searchLink fieldCode="AR" term="%22Bunnell%2C+Craig+A%2E%22">Bunnell, Craig A.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Parker%2C+Leroy+M%2E%22">Parker, Leroy M.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Garber%2C+Judy+E%2E%22">Garber, Judy E.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Winer%2C+Eric+P%2E%22">Winer, Eric P.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Harris%2C+Jay+R%2E%22">Harris, Jay R.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Powell%2C+Simon+N%2E%22">Powell, Simon N.</searchLink><relatesTo>4</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22">International Journal of Radiation Oncology, Biology, Physics</searchLink>. Feb2006, Vol. 64 Issue 2, p496-504. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Breast+cancer%22">Breast cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Radiotherapy%22">Radiotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+therapy%22">Drug therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Doxorubicin%22">Doxorubicin</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink>
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  Label: Abstract
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  Data: Purpose: To evaluate the safety and feasibility of concurrent radiation therapy and paclitaxel-based adjuvant chemotherapy, given either weekly or every 3 weeks, after adjuvant doxorubicin and cyclophosphamide (AC). Methods and Materials: After definitive breast surgery and AC chemotherapy, 40 patients with operable Stage II or III breast cancer received protocol-based treatment with concurrent paclitaxel and radiation therapy. Paclitaxel was evaluated on 2 schedules, with treatment given either weekly × 12 weeks (60 mg/m2), or every 3 weeks × 4 cycles (135–175 mg/m2). Radiation fields and schedules were determined by the patient’s surgery and pathology. The tolerability of concurrent therapy was evaluated in cohorts of 8 patients as a phase I study. Results: Weekly paclitaxel treatment at 60 mg/m2 per week with concurrent radiation led to dose-limiting toxicity in 4 of 16 patients (25%), including 3 who developed pneumonitis (either Grade 2 [1 patient] or Grade 3 [2 patients]) requiring steroids. Efforts to eliminate this toxicity in combination with weekly paclitaxel through treatment scheduling and CT-based radiotherapy simulation were not successful. By contrast, dose-limiting toxicity was not encountered among patients receiving concurrent radiation with paclitaxel given every 3 weeks at 135–175 mg/m2. However, Grade 2 radiation pneumonitis not requiring steroid therapy was seen in 2 of 24 patients (8%) treated in such a fashion. Excessive radiation dermatitis was not observed with either paclitaxel schedule. Conclusions: Concurrent treatment with weekly paclitaxel and radiation therapy is not feasible after adjuvant AC chemotherapy for early-stage breast cancer. Concurrent treatment using a less frequent paclitaxel dosing schedule may be possible, but caution is warranted in light of the apparent possibility of pulmonary injury. [Copyright &y& Elsevier]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1016/j.ijrobp.2005.07.975
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        Text: English
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        PageCount: 9
        StartPage: 496
    Subjects:
      – SubjectFull: Breast cancer
        Type: general
      – SubjectFull: Radiotherapy
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      – SubjectFull: Drug therapy
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      – SubjectFull: Doxorubicin
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              Text: Feb2006
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