Hospice news

Research published in the November issue of the Journal of the National Cancer Institute reported that oncologists can safely give breast cancer patients radiation treatment and taxane drugs without increasing the risk of radiation pneumonitis. Radiation pneumonitis is an interstitial pulmonary inflammation that can develop in as many as 5 to 15 percent of patients with thoracic radiation treatment. Acute radiation pneumonitis occurs within one to six months following treatment. Symptoms can include low-grade fever, cough, and fullness in the chest. Severe reactions can result in dyspnea, pleuritic chest pain, hemoptysis, acute respiratory distress, and death. Fibrosis can occur without previous pneumonitis, but once pneumonitis occurs, fibrosis is almost certain to take place. The radiographic hallmark of radiation pneumonitis is a diffuse infiltrate corresponding to a previous radiation treatment field. According to a study conducted by Dr. Tse-Kuan Yu and colleagues at the University of Texas M. D. Anderson Cancer Center, new techniques for administering radiation therapy have made radiation-related pneumonitis much less common. However, there have been some recent reports that linked taxane chemotherapy in the increased risk of radiation-induced injury when used in conjunction with radiation treatment. The research team conducted a randomized study comparing paclitaxel-FAC (5-flurouracil, doxorubicin, and cyclophosphamide) with FAC alone in breast cancer patients, some of whom also underwent radiation therapy. The researchers analyzed these data to determine whether patients given the taxane drug had an increased risk of radiation-induced pneumonitis. The results of the study showed that patients with breast cancer treated with sequential paclitaxel, FAC, and radiation therapy appeared to have a very low rate of clinically relevant radiation pneumonitis that was no different from that of patients treated with FAC alone. In total, 5 percent of the 100 patients given paclitaxel developed pneumonitis compared with 4.5 percent of the 89 patients given FAC only. In the studies that found an increased risk, paclitaxel had been given just before or during radiation therapy. In the current study, patients received radiation three to four months after the end of paclitaxel treatment. The research team concluded that the risk of radiation pneumonitis should not be a determining factor in whether to use radiotherapy in conjunction with taxane drugs for breast cancer treatment. They agree that further research is necessary to explore the association between the risk of radiation pneumonitis and the combination of paclitaxel chemotherapy and radiation therapy. (Source: J Natl Cancer Inst. 2004; 96(22): 1676-1681.)