Abstract
858 Background: We have previously reported the feasibility of sequential use of docetaxel chemotherapy after four cycles of AC chemotherapy in early breast cancer (29th ESMO Congress, Abstract 252-P). Sequential use of docetaxel delays the use of postoperative radiation and can compromise the loco-regional control. We have designed this study to evaluate the feasibility of concurrent docetaxel and radiation therapy after four cycles of AC chemotherapy in patients with high risk operable breast cancer. Methods: Females between 18–50 years of age with T2-T3 lesions, four or more positive axillary lymph nodes and hormone receptor negative tumors were eligible. All patients had modified radical mastectomy. Four cycles of AC at 60/600mg/m2 were followed by four cycles of docetaxel at 75mg/m2. Concurrent radiation to chest wall and peripheral lymphatics was started with the third cycle of docetaxel. A dose of 50 Gy in 5 weeks or equivalent was delivered. Successful completion of treatment in 18 out of 20 patients was chosen as an index of feasibility. CTC version 2.0 of NCI was used. Results: All the twenty enrolled patients successfully completed the planned treatment. Radiation was completed within 6 months of surgery in 90%. Grade 1 radiation dermatitis was seen in 60% and grade 2 in 20%. Significant grade 3 toxicities included neutropenia and diarrhea in 25% and 20% respectively. Febrile neutropenia was seen in 15%. At a median follow up of 8 months (range 4–13 months) no local recurrence has been seen. Conclusions: This treatment schedule is feasible in patients with high-risk operable breast cancer. This is the first report incorporating concurrent use of docetaxel with chest wall irradiation. No significant financial relationships to disclose.
Published Version
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