Unwanted Side Effects with Combination Treatment
Treating breast cancer patients with radiation plus chemotherapy is often an effective strategy, but a new study by researchers at Massachusetts General Hospital (MGH) in Boston has determined that certain combinations may increase the incidence of an inflammatory condition called radiation pneumonitis.
Writing in the Journal of the National Cancer Institute, the researchers, led by Dr. Alphonse Taghian, suggest that doctors should use extra caution when administering radiation therapy with the chemotherapy drug paclitaxel.
Radiation pneumonitis is an acute inflammation of the lung, and symptoms include shortness of breath, cough and low-grade fever. Once identified, the success rate of treatment for pneumonitis is almost 100 percent.
"The bottom line is that these treatments can cause this potentially serious form of lung inflammation, so we need to be alert and wary of it," said Dr. Simon Powell, a senior investigator on the study and radiation oncologist at MGH.
Taghian's team found that when breast cancer patients were given chemotherapy that included paclitaxel in addition to radiation therapy directed at the breast-chest wall, radiation pneumonitis developed in six of the 41 patients, or 14.6 percent. For patients treated with chemotherapy drugs that did not include paclitaxel, the rate of lung inflammation was only 1.1 percent.
"This complication should not make the patient refuse paclitaxel," cautioned Taghian. "It can be delivered safely in combination with radiation, but we need to use extra caution in the placement of the radiation beams," he said.
"This is a miniature alert on something doctors don't always look for," added Powell. "We had to look carefully to spot the occurrence of this condition; now we can alert others to do the same."
SOURCES:
Journal of the National Cancer Institute, December 5, 2001; 93(23):1806-1811
Massachusetts General Hospital (http://www.mgh.Harvard.edu)
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