- 作者：Harold J. Burstein ; Jennifer R. Bellon ; Sharon Galper ; Hsiao-Ming Lu ; Irene Kuter ; Alphonse G. Taghian ; Julia Wong ; Rebecca Gelman ; Craig A. Bunnell ; Leroy M. Parker et al.
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2006
- 出版时间：1 February 2006
- 年：2006
- 卷：64
- 期：2
- 页码：496-504
- 全文大小：133 K
Methods and Materials: After definitive breast surgery and AC chemotherapy, 40 patients with operable Stage II or III breast cancer received protocol-based treatment with concurrent paclitaxel and radiation therapy. Paclitaxel was evaluated on 2 schedules, with treatment given either weekly × 12 weeks (60 mg/m2), or every 3 weeks × 4 cycles (135–175 mg/m2). Radiation fields and schedules were determined by the patient’s surgery and pathology. The tolerability of concurrent therapy was evaluated in cohorts of 8 patients as a phase I study.
Results: Weekly paclitaxel treatment at 60 mg/m2 per week with concurrent radiation led to dose-limiting toxicity in 4 of 16 patients (25 % ), including 3 who developed pneumonitis (either Grade 2 [1 patient] or Grade 3 [2 patients]) requiring steroids. Efforts to eliminate this toxicity in combination with weekly paclitaxel through treatment scheduling and CT-based radiotherapy simulation were not successful. By contrast, dose-limiting toxicity was not encountered among patients receiving concurrent radiation with paclitaxel given every 3 weeks at 135–175 mg/m2. However, Grade 2 radiation pneumonitis not requiring steroid therapy was seen in 2 of 24 patients (8 % ) treated in such a fashion. Excessive radiation dermatitis was not observed with either paclitaxel schedule.
Conclusions: Concurrent treatment with weekly paclitaxel and radiation therapy is not feasible after adjuvant AC chemotherapy for early-stage breast cancer. Concurrent treatment using a less frequent paclitaxel dosing schedule may be possible, but caution is warranted in light of the apparent possibility of pulmonary injury.