Radiotherapy with concurrent docetaxel for advanced and recurrent breast cancer
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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.
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.
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.
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 wordsBreast cancer Docetaxel Concurrent chemotherapy Radiotherapy
Magnetic resonance imaging
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- 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).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).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
- 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).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
- 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).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
- 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