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Breast Cancer

, Volume 10, Issue 3, pp 268–274 | Cite as

Radiotherapy with concurrent docetaxel for advanced and recurrent breast cancer

  • Kumiko Karasawa
  • Kuniaki Katsui
  • Kaori Seki
  • Mari Kohno
  • Nahoko Hanyu
  • Sachiko Nasu
  • Hiroyuki Muramatsu
  • Katsuya Maebayashi
  • Norio Mitsuhashi
  • Shunsuke Haga
  • Tsunehito Kimura
  • Isamu Takahashi
Original Article

Abstract

Background

Docetaxel has shown remarkable radiosensitizing propertiesin vitro. In this study we investigated whether the addition of docetaxel to radiotherapy enhanced tumor response in patients with advanced or recurrent breast cancer.

Methods

A total of 35 patients were enrolled in this study. Docetaxel was administered concurrently during radiotherapy. Radiation doses were 54 to 69 Gy (median 60 Gy). In those enrolled through January 2000, docetaxel 40 mg/m2 was administered biweekly (once every two weeks), with subsequent dose adjustments based on tolerance and bone marrow and liver function. Beginning in February 2000, a weekly docetaxel schedule was used instead. This new regimen was based on data suggesting reduced myelosuppression with this regimen. The weekly dose rate was 20 mg/m2, with dose reductions for impaired organ function.

Results

All patients were evaluated for toxicity and response and a total of 40 irradiated sites were evaluated for local response. The overall response rate of irradiated sites was 95% and the CR rate was 68%. CR and PR were achieved in 40%, 37% of patients, respectively. Acute toxicities were tolerated by most patients: 17% had Grade 3-4 neutropenia, 6% had Grade 3-4 radiation dermatitis, and 3% had Grade 3-4 pneumonitis.

Conclusion

The combination of docetaxel with radiotherapy is an active and safe regimen in patients with inoperable advanced or recurrent breast cancer. We determined the recommended dose of docetaxel with concomitant radiotherpy to be 20 mg/m2 weekly for a Phase II study. Further study is necessary to assess the impact of this treatment on long-term outcome.

Key words

Breast cancer Docetaxel Concurrent chemotherapy Radiotherapy 

Abbreviations

CR

Complete response

PR

Partial response

CT

Computed tomography

MRI

Magnetic resonance imaging

SD

Stable disease

PD

Progressive disease

ns

Number of site

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References

  1. 1).
    Hennequin C, Giocanti N, Favaudon V: Interaction of ionizing radiation with paclitaxel (Taxol) and docetaxel (Taxotere) in HeLa and SQ20B cells.Cancer Res 56: 1842–1850, 1996.PubMedGoogle Scholar
  2. 2).
    Matsuura M, Hasegawa M, Hayakawa K, Kawashima M, Nasu S, Nakamura Y, Hayakawa K, Mitsuhashi N, Niibe H: Experimental study of the effects on apoptosis of docetaxel alone and in combination with irradiation.Oncol Rep 7: 289–293, 2000.PubMedGoogle Scholar
  3. 3).
    Mason KA, Hunter NR, Milas M, Abbruzzese JL, Milas L: Docetaxel enhances tumor radioresponsein vivo.Clin Cancer Res 3: 2431–2438, 1997.PubMedGoogle Scholar
  4. 4).
    Mason KA, Kishi K, Hunter N, Buchmiller L, Akimoto T, Komaki R, Milas L: Effect of docetaxel on the therapeutic ratio of fractionated radiotherapyin vivo.Clin Cancer Res 5: 4191–4198, 1999.PubMedGoogle Scholar
  5. 5).
    Valero V, Holmes FA, Walters RS, Theriault RL, Esparza L, Fraschini G, Fonseca GA, Bellet RE, Buzdar AU, Hortobagyi GN: Phase II trial of docetaxel: a new, highly effective antineoplastic agent in the management of patients with anthracycline-resistant metastatic breast cancer.J Clin Oncol 13: 2886–2894, 1995.PubMedGoogle Scholar
  6. 6).
    Taguchi T, Furue H, Niitani H, Ishitani K, Kanemaru R, Hasegawa K, Ariyoshi H, Noda K, Furuse K, Fukuoka M, Yakushiji M, Kashimura M: Phase I clinical trial of RP56976 (docataxel) a new anticancer drug.Jpn J Cancer Chemother 21: 1997–2005, 1994 (in Japanese with English abstract).Google Scholar
  7. 7).
    Teng M, Choy H, De Vore RD,et al: Phase I trial of outpatient weekly docetaxel and concurrent therapy for stage III unresectable non-small-cell lung cancer: A Vanderbilt Cancer Center Affiliate Network (VVCAN) trial (abstract).Proc Am Soc Clin Oncol 17:503a, 1998.Google Scholar
  8. 8).
    Hainsworth JD, Burris HA 3rd, Erland JB, Thomas M, Greco FA: Phase I trial of docetaxel administered by weekly infusion in patients with advanced refractory cancer.J Clin Oncol 16: 2164–2168, 1998.PubMedGoogle Scholar
  9. 9).
    Koukourakis MI, Bahlitzanakis N, Froudarakis M, Giatromanolaki A, Georgoulias V, Koumiotaki S, Christodoulou M, Kyrias G, Skarlatos J, Kostantelos J, Beroukas K: Concurrent conventionally factionated radiotherapy and weekly docetaxel in the treatment of stage IIIb non-small-cell lung carcinoma.Br J Cancer 11: 1792–1796, 1999.CrossRefGoogle Scholar
  10. 10).
    Loffler TM, Freund W, Droge C,et al: Activity of weekly taxotere in patients with matastatic breast cancer.Proc Am Soc Clin Oncol 16: 435a, 1998.Google Scholar
  11. 11).
    Mauer AM, Masters GA, Haraf DJ, Hoffman PC, Watson SM, Golomb HM, Vokes EE: Phase I study of docetaxel with concomitant thoracic radiation therapy.J Clin Oncol 16: 159–164, 1998.PubMedGoogle Scholar
  12. 12).
    Rubin P, Constine LS 3rd, Fajardo LF, Phillips TL, Wasserman TH: EORTC Late Effects Working Group. Overview of late normal tissues (LENT) scoring system.Radiother Oncol 35: 9–10, 1995.PubMedCrossRefGoogle Scholar
  13. 13).
    Cortes JE, Pazdur R: Docetaxel.J Clin Oncol 13: 2643–2655, 1995.PubMedGoogle Scholar
  14. 14).
    Fumoleau P, Chevallier B, Kerbrat P, Krakowski Y, Misset JL, Maugard-Louboutin C, Dieras V, Azli N, Bougon N, Riva A, Roche H: A multicentre phase II study of the efficacy and safety of docetaxel as firstline treatment of advanced breast cancer: report of the Clinical Screening Group of the EORTC.Ann Oncol 7: 165–171, 1996.PubMedGoogle Scholar
  15. 15).
    Chevallier B, Fumoleau P, Kerbrat P, Dieras V, Roche H, Krakowski I, Azli N, Bayssas M, Lentz MA, Van Glabbeke M: Docetaxel is a major cytotoxic drug for the treatment of advanced breast cancer: a phase II trial of the Clinical Screening Cooperative Group of the European Organization for Research and Treatment of Cancer.J Clinc Oncol 13: 314–322, 1995.Google Scholar
  16. 16).
    Bellon JR, Lindsley KL, Ellis GK, Gralow JR, Livingston RB, Austin Seymour MM: Concurrent radiation therapy and paclitaxel or docetaxel chemotherapy in high-risk breast cancer.Int J Radiat Oncol Biol Phys 48: 393–397, 2000.PubMedGoogle Scholar
  17. 17).
    Formenti SC, Symmans WF, Volm M, Skinner K, Cohen D, Spicer D, Danenberg PV: Concurrent paclitaxel and radiation therapy for breast cancer.Semin Radiat Oncol 9 (2 Suppl l): 34–42, 1999.PubMedGoogle Scholar
  18. 18).
    Choy H: Combining taxanes with radiation for solid tumors.Int J Cancer 9: 113–127, 2000.CrossRefGoogle Scholar
  19. 19).
    Milas L, Milas MM, Mason KA: Combination of taxanes with radiation: preclinical studies.Semin Radiat Oncol 9 (2 Suppl 1): 12–26, 1999.PubMedGoogle Scholar
  20. 20).
    Koukourakis MI, Giatromanolaki A, Kakolyris S, Froudarakis M, Georgoulias V, Retalis G, Bahlitzanakis N: Phase I / II dose escalation study of docetaxel and carboplatin combination supported with amifostine and GM-CSF in patients with incomplete response following docetaxel chemo-radiotherapy: additional chemotherapy enhances regression of residual cancer.Med Oncol 17: 135–143, 2000.PubMedCrossRefGoogle Scholar
  21. 21).
    Mason K, Staab A, Hunter N, McBride W, Petersen S, Terry N, Milas L: Enhancement of tumor radioresponse by docetaxel: Involvement of immune system.Int J Oncol 18: 599–606, 2001.PubMedGoogle Scholar
  22. 22).
    Karasawa K, Shinoda H, Katsui K, Seki K, Kohno M, Hanyu N, Nasu S, Muramatsu H, Maebayashi K, Mitsuhashi N, Yoshihara T: Radiotherapy with concurrent docetaxel and carboplatin for head and neck cancer.Anticancer Res 22: 3785–3788, 2002.PubMedGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 2003

Authors and Affiliations

  • Kumiko Karasawa
    • 1
    • 2
  • Kuniaki Katsui
    • 1
    • 3
  • Kaori Seki
    • 1
  • Mari Kohno
    • 1
  • Nahoko Hanyu
    • 1
  • Sachiko Nasu
    • 1
  • Hiroyuki Muramatsu
    • 1
  • Katsuya Maebayashi
    • 1
  • Norio Mitsuhashi
    • 1
  • Shunsuke Haga
    • 4
  • Tsunehito Kimura
    • 5
  • Isamu Takahashi
    • 6
  1. 1.Department of RadiologyTokyo Women’s Medical University School of MedicineJapan
  2. 2.Department of RadiologyJuntendo University School of MedicineJapan
  3. 3.Department of RadiologyOkayama University Graduate School of Medicine and DentistryJapan
  4. 4.Department of SurgeryTokyo Women’s Medical University Daini HospitalJapan
  5. 5.Department of Surgery IITokyo Women’s Medical University School of MedicineJapan
  6. 6.Department of SurgeryEdogawa HospitalJapan

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