Feasibility of concurrent weekly paclitaxel and radiotherapy in adjuvant treatment of breast cancer: An experience from India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11536-e11536
Author(s):  
Mohan Kumar Somashekar ◽  
Murali Subramanian V ◽  
Nirmala Srikantaiah S ◽  
Arul Ponni TR ◽  
Rajeev A G ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Conservative Surgery ◽  
Weekly Paclitaxel ◽  
Severe Toxicity ◽  
Breast Cancer Patients ◽  
Skin Reactions ◽  
Breast Conservative Surgery ◽  
Whole Breast Radiotherapy

e11536 Background: Majority of the breast cancer patients require adjuvant radiotherapy and chemotherapy for better locoregional and distant control. However the sequencing of these is still debatable . Hence concurrent chemo radiation may avoid the delay in either of the adjuvant therapies. Anthracyclines are not used concurrently with radiation because of severe toxicity. Hence the current study was taken to assess the feasibility of concurrent weekly paclitaxel and radiotherapy in adjuvant treatment of ca breast. Methods: A prospective study was conducted on 22 breast cancer patients, post modified radical mastectomy or breast conservative surgery from November 2008 to April 2010. Chest wall or whole breast radiotherapy was given on Tele Cobalt or Linac for a dose of 50 – 50.4Gy in conventional fractionation. Boost of 16 Gy was given to tumor cavity with photons or electrons for those undergone breast conservative surgery. All patients received Inj.paclitaxel 60 mg/m2 once a week for 5 weeks. After completion of RT, paclitaxel dose was increased to 80mg/m2 for remaining 7 cycles. This was followed by anthracycline based treatment sequentially as per standard adjuvant guidelines. Patients assessed weekly and toxicities graded based on CTC version 03. The minimum follow up was 2 months after completion of chemoradiation. Chi-Square test and Fisher exact test were used to interpret the results with literature. Results: See table below. Skin reaction was more frequent and severe of all toxicities (p=0.003).With available literatures on adjuvant radiation alone the grade III and higher skin reactions are 3% but in our study it is 28% because of which 5/22 (22%) patients had interruption of both chemotherapy and radiation. Conclusions: Concurrent chemoradiation with weekly paclitaxel in adjuvant treatment of ca breast is associated with more skin reactions which may result in significant treatment interruptions. It should be practiced cautiously which requires further randomized control studies to assess the toxicities in detail. [Table: see text]

Feasibility of concurrent weekly paclitaxel and radiotherapy in node-positive breast cancer: An experience from India.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 201-201
Author(s):  
Mohan Kumar ◽  
Murali Subramanian ◽  
Rajeev AG ◽  
Arul Ponni ◽  
Nirmala S ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Conservative Surgery ◽  
Weekly Paclitaxel ◽  
Adjuvant Radiation ◽  
Breast Cancer Patients ◽  
Skin Reactions ◽  
Breast Conservative Surgery ◽  
Node Positive

201 Background: Breast cancer patients with positive node and extra nodal spread are at a higher risk for distant metastases and they require immediate adjuvant chemotherapy. Similarly patients after breast conservative surgery or with patholgical T3, T4 disease require adjuvant radiation as early as possible. Taxanes have shown good response in node positive patients and are combined in many adjuvant chemotherapy regimens. Hence the current study was taken to assess the feasibility of concurrent weekly paclitaxel and radiotherapy. Methods: A prospective study was conducted on 22 female breast cancer patients after modified radical mastectomy or breast conservative surgery with pathologically positive node. Chest wall or whole breast radiotherapy was given on Tele Cobalt or Linac for a dose of 50 – 50.4Gy in conventional fractionation. Boost of 16 Gy was given to tumor cavity for those undergone breast conservative surgery. All patients received Inj. paclitaxel 60 mg/m2 once a week for 5 weeks. After completion of RT, paclitaxel dose was increased to 80mg/m2 for remaining 7 cycles. This was followed by anthracycline-based treatment sequentially as per standard adjuvant guidelines. Patients assessed weekly and toxicities graded based on CTC version 03. The minimum follow up was 2 months after completion of chemoradiation. Chi-Square test and Fisher exact test were used to interpret the results with literature. Results: See table. Skin reaction was more frequent and severe of all toxicities (p=0.003). With available literatures on adjuvant radiation alone the grade III and higher skin reactions are 3% but in our study it is 28% because of which 5/22 (22%) patients had interruption of both chemotherapy and radiation. Conclusions: Concurrent chemoradiation with weekly paclitaxel in adjuvant treatment of ca breast is associated with more Skin reactions which may result in significant treatment interruptions. It should be practiced cautiously which requires further randomized control studies to assess the toxicities in detail. [Table: see text]

scholarly journals Dose-Dense Docetaxel versus Weekly Paclitaxel following Dose-Dense Epirubicin and Cyclophosphamide as Adjuvant Chemotherapy in Node-Positive Breast Cancer Patients: A Retrospective Cohort Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Sara Khoshroo ◽  
Saleh Sandoughdaran ◽  
Parisa Sabetrasekh ◽  
Parastoo Hajian ◽  
Pegah Bikdeli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Weekly Paclitaxel ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Positive ◽  
Dose Dense ◽  
Positive Breast Cancer

Background/Aims. The anthracycline and taxane-based chemotherapy regimens are the standard adjuvant treatment of node-positive breast cancer patients. Although it was believed that docetaxel and paclitaxel are similarly effective as adjuvant treatment in node-positive breast cancer, recent studies report that weekly paclitaxel is superior to weekly and triweekly docetaxel schedules in terms of overall survival (OS) and disease-free survival (DFS). However, to the best of our knowledge, no study has compared weekly paclitaxel with a dose-dense regimen of docetaxel. The current study is aimed at evaluating the outcome of women with node-positive breast cancer who had received weekly paclitaxel compared with those treated with dose-dense docetaxel. Methods. This study included patients from two prospective studies conducted in our institute from April 2007 to March 2009. Ninety-one women with axillary lymph node-positive breast cancer who had received four cycles of dose-dense epirubicin and cyclophosphamide were treated with either weekly paclitaxel (80 mg/m2) for 12 doses or biweekly docetaxel (75 mg/m2) for four cycles. Results. After a median follow-up of 88 and 109 months, 11 (23.4%) and 10 (22.7%) patients had experienced disease recurrence ( p = 0.16 ), while 10 (21.3%) and 5 (11.4%) patients had died in the paclitaxel and docetaxel arm, respectively ( p = 0.56 ). No significant difference could be seen in 5-year DFS or OS among groups (HR: 0.58; 95% CI: 0.19–1.81, p = 0.35 ; HR: 0.58; 95% CI: 0.19–1.81, p = 0.35 , respectively). Conclusion. In conclusion, both evaluated adjuvant chemotherapy regimens have comparable effectiveness regarding DFS and OS.

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