Late pancreatic toxicity in patients with breast cancer after taxane-anthracycline–based neoadjuvant and adjuvant chemotherapy.

Abstract

e11043 Background: Gastrointestinal toxicity in patients treated with chemotherapy is usually considered as early toxicity in short time after chemotherapy. Some gastrointestinal abnormalities are found during long follow-up after the end of chemotherapy. We conducted a retrospective analisis of toxicity of breast cancer patients during neoadjuvant and adjuvant chemotherapy and after chemotherapy. Methods: We retrospectively have analyzed toxicity in 1,643 patients treated for HER2-negative breast cancer between 1993 and 2003. All patients received taxane-anthracycline–based chemotherapy regimens (paclitaxel 175 mg/m2 and doxorubicin 50 mg/m2 or docetaxel 75 mg/m2 and doxorubicin 50 mg/m2), at 21 days intervals, for 4 cycles as neoadjuvant and 4 cycles as adjuvant. All patients underwent mastectomies between fourth and fifth cycles of chemotherapy. Interval between fourth and fifth cycles was not longer then 8 weeks. Results: The mean age was 51.6 years (28–70 years). The follow-up mean was 2.9 years (1-5 years) after the end of chemotherapy. All patients had normal metabolic tests before chemotherapy. Acute pancreatoxicity was found in 9.1% patients during 1-8 cycles of chemotherapy. 5.2% patients had abdomen pain, metabolic abnormalities and ultrasound signs of acute pancreatitis. Only metabolic abnormalities and ultrasound signs (subclinical form) were found in 3.9% patients. During follow-up late pancreatoxicity (chronic pancreatitis) was diagnosed in 20.6% patients. 50% patients with chronic pancreatitis manifested during follow-up period had had pancreatoxicity during neoadjuvant and adjuvant chemotherapy. Conclusions: These results show the need to control metabolic tests, to perform ultrasound scanning of abdomen and to adapt treatment according to the pancreatic function during chemotherapy and for a long time after chemotherapy. No significant financial relationships to disclose.