2. Department of General Surgery, Faculty of Medicine, Assiut University, Egypt.
Purpose: To assess the safety and efficacy of the use of concurrent radiation therapy and docetaxel in adjuvant treatment oflocally advanced breast cancer (LABC).
Patients and methods: Between February 2009 and January 2013, 62 patients with LABC who underwent primary mastectomy or neoadjuvant chemotherapy (FEC) followed by mastectomy at Assiut University Hospitals were entered into this trial. Three to five weeks after mastectomy or after the last dose of adjuvant FEC, patients were given concurrent chemoradiotherapy. Weekly intravenously docetaxel (30 mg/m2) was given over 9 weeks.
Results: The median follow-up for all patients is 32 months (range 12–63). Fortyeight patients (77.4%) remain alive, 12 patients (19.4%) died due to breast cancer, and 2 (3.2%) from other nonrelated causes. The 3-year rate of local recurrence free survival (LRFS) and disease free survival (DFS)were 93.8% (95% CI, 87.8-99.8%) and 70.2% (95% CI, 58.8-81.6%, Figure 1) respectively. The 3-year overall survival rate was 89.4% (95% confidence interval [95% CI], 81.7-97.1%; Figure 2). Four (6.4%) patients experienced locoregional recurrence as the first site of recurrence and 22 (35.5%) patients developed distant metastases. Acute toxicities were moderate during concomitant chemoradiotherapy. Five patients (8.1%) had grade 3-4 radiation dermatitis. Grade 3-4 radiation pneumonitis developed in 2 patients. Long-term toxicity was rare.
Conclusion: Concurrent docetaxel and radiotherapyis an acceptable adjuvant regimen for patients withLABC. Although it does not apparently improve local control and/or survival, it shortened total treatment time, and was well tolerated.
Keywords: Concurrent radiation therapy, docetaxel, breast cancer