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ABSTRACT: Primary chemotherapy is increasingly used in patients with large operable breast cancer. Docetaxel and epirubicin are the most active agents in breast cancer treatment.
To evaluate clinical response rate, breast conserving surgery and pathological response rate in patients with large operable breast cancer treated with docetaxel followed by docetaxel and epirubicin as primary chemotherapy.
Patients with operable breast cancer more than 3 cm in the longest diameter with T2N0, T2N1 and T3N0 disease were enrolled. Patients were treated with three cycles of docetaxel 100 mg/m2 followed by three cycles of docetaxel 75 mg/m2 and epirubicin 90 mg/m2 prior to surgery.
Sixty-five patients were enrolled between 09/2002 and 12/2005. The median age was 48.9 years and 72.3% were premenopausal. Median tumour size was 4.26 cm, 10.8% were T3 tumours and 38.5% had clinical positive lymph nodes. Of the tumours 58.5% were grade 1/2, 33.9% ER positive and 21.5% c-erb negative. All six cycles were administered to 62 patients; six cycles were delayed and five had dose reductions. Complete clinical response occurred in 41.5% of patients and partial response in 49.2%. Breast conserving surgery was performed in 30% of patients however it was feasible in 57%. Complete pathological response occurred in both primary tumour and nodes in 28%, and in 34% just in the primary tumour. Nine percent of cases had neutropenia and 7.7% febrile neutropenia, and two cases had a hypersensitivity reaction to docetaxel. One associated treatment death occurred.
Docetaxel followed by epirubicin and docetaxel as primary chemotherapy results in a high clinical and pathological response rate. The majority of adverse events were predictable and manageable.
European journal of gynaecological oncology 02/2007; 28(6):447-50. · 0.47 Impact Factor
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ABSTRACT: BackgroundImaging of peritoneal carcinomatosis is a well-known problem even for technologies as recent as computed tomography (CT). The purpose of this study was to evaluate whether CT performed after induced pneumoperitoneum (CT-PP) could have a higher sensitivity in the detection of peritoneal implants over conventional CT.MethodsFive patients with known ovarian malignancies underwent standard CT and CT-PP. Exploratory laparotomy was performed with a maximum interval of 7 days from the last imaging procedure. Results were prospectively compared with surgical findings on a compartment to compartment basis.ResultsCT-PP was well-tolerated with no serious adverse reactions registered. The anterior and visceral peritoneum, the paracolic gutters and subphrenic areas were particularly well depicted but not the pelvis which was poorly evaluated in all cases. CT-PP detected all the three cases where peritoneal carcinomatosis was present even when metastatic nodules were smaller than 2 mm; it also showed intraabdominal adhesions in two patients, an important finding that precludes the use of intraperitoneal chemotherapy.ConclusionsWith CT-PP there seems to be a reduction in the threshold of detectability of peritoneal implants. The direct demonstration of intraperitoneal adhesions is an important secondary finding. Disadvantages of CT-PP are (1) it is a time-consuming method and (2) it does not evaluate all the peritoneal recesses potentially involved in peritoneal carcinomatosis.
Abdominal Imaging 12/1994; 20(1):52-55. · 1.73 Impact Factor
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ABSTRACT: Imaging of peritoneal carcinomatosis is a well-known problem even for technologies as recent as computed tomography (CT). The purpose of this study was to evaluate whether CT performed after induced pneumoperitoneum (CT-PP) could have a higher sensitivity in the detection of peritoneal implants over conventional CT.
Five patients with known ovarian malignancies underwent standard CT and CT-PP. Exploratory laparotomy was performed with a maximum interval of 7 days from the last imaging procedure. Results were prospectively compared with surgical findings on a compartment to compartment basis.
CT-PP was well-tolerated with no serious adverse reactions registered. The anterior and visceral peritoneum, the paracolic gutters and subphrenic areas were particularly well depicted but not the pelvis which was poorly evaluated in all cases. CT-PP detected all the three cases where peritoneal carcinomatosis was present even when metastatic nodules were smaller than 2 mm; it also showed intraabdominal adhesions in two patients, an important finding that precludes the use of intraperitoneal chemotherapy.
With CT-PP there seems to be a reduction in the threshold of detectability of peritoneal implants. The direct demonstration of intraperitoneal adhesions is an important secondary finding. Disadvantages of CT-PP are (1) it is a time-consuming method and (2) it does not evaluate all the peritoneal recesses potentially involved in peritoneal carcinomatosis.
Abdominal Imaging 20(1):52-5; discussion 56-7. · 1.73 Impact Factor
