This may include scarring or inflammation of the lung tissue. What is docetaxel? Docetaxel (Taxotere) associated scleroderma-like changes of the lower extremities. This typically begins two to three weeks after treatment starts. Dose-dense doxorubicin monotherapy (75 mg/m2) followed by dose-dense docetaxel (100 mg/m2) resulted in a rate of grade 3 HFS of 42 % in one of the studies despite corticosteroid premedication [28]. Spot the signs and symptoms of secondary breast cancer, the number of blood cells has returned to normal, Find out more about how breast cancer treatment can affect fertility, Spread to the tissues and lymph nodes around the chest, neck and under the breastbone (known as regional recurrence or locally advanced breast cancer), Spread to other parts of the body (secondary breast cancer), Pain, redness/discolouration, heat and swelling of the calf or thigh, Swelling, redness or tenderness where a central line is inserted to give chemotherapy, for example in the arm, chest area or up into the neck. The number of white blood cells usually returns to normal before your next course of chemotherapy is due. The patient was hospitalized for severe pain. Remember your hair helps keep you warm in cold weather, so a hat is particularly important in cold weather or to protect you from the sun. Thus, the current report presents the case of a breast cancer patient who developed a significantly delayed skin reaction one day after docetaxel extravasation, a rare skin manifestation, and relapsed one week subsequently. Copyright: Merative US L.P. 1973, 2023. Department of Pharmacy, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, 300 W 10th Ave, Columbus, OH 43210, USA, Department of Pharmacy, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, 1145 Olentangy River Road, Columbus, OH 43212, USA, Division of Medical Oncology, Department of Internal Medicine, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University Medical Center, B421 Starling Loving Hall, 320 West 10th Ave, Columbus, OH 43210, USA, Division of Medical Oncology, Department of Internal Medicine, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University Medical Center, B411 Starling Loving Hall, 320 West 10th Ave, Columbus, OH 43210, USA, Division of Medical Oncology, Department of Internal Medicine, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University Medical Center, B405 Starling Loving Hall, 320 West 10th Ave, Columbus, OH 43210, USA, Division of Medical Oncology, Department of Internal Medicine, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University Medical Center, B406 Starling Loving Hall, 320 West 10th Ave, Columbus, OH 43210, USA, Division of Medical Oncology, Department of Internal Medicine, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University Medical Center, B424 Starling Loving Hall, 320 West 10th Ave, Columbus, OH 43210, USA, Division of Medical Oncology, Department of Internal Medicine, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University Medical Center, B407 Starling Loving Hall, 320 West 10th Ave, Columbus, OH 43210, USA, Division of Medical Oncology, Department of Internal Medicine, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University Medical Center, B401 Starling Loving Hall, 320 West 10th Ave, Columbus, OH 43210, USA, ude.cmuso@ikswolosew.treboR. Travel and vaccinations Docetaxel may cause changes to the appearance of your nails on your fingers and toes. Talk to your oncology care team so they can prescribe medications to help you manage nausea and vomiting. Your fingernails/toenails may become dark, brittle or fall off. Probable risk factors include high density of sweat glands, absence of folliculosebaceous units, thick stratum corneum, and wide dermal papillae [23]. Docetaxel can cause your body to hold too much fluid, which can be a serious side effect. All subjects who met the above criteria were used as the denominator to calculate the incidence of severe docetaxel-induced skin toxicity in our study. I had my first Taxotere on Monday and am not coping at all. Five patients (14.7 %) experienced grade 3 skin toxicity events attributable to docetaxel, a significantly higher rate than previously reported for docetaxel dosed at 75100 mg/m2. This is not a complete list of side effects and others may occur. 304 Study Group. A phase II study by Puhalla and colleagues demonstrated that the administration of docetaxel (75 mg/m2) after AC (60/600 mg/m2) in a dose-dense schedule resulted in higher incidence of HFS than the reverse sequence (29 vs 4 % grade 2/3 HFS, respectively) [33]. 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This is a rare side effect, but if you become breathless or develop a dry cough during or in the few weeks after your treatment, let your treatment team know. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. While on cancer treatment, and for a period after, you may need to adjust your schedule to manage fatigue. stomach pain or tenderness, diarrhea, or fever. 2013 Oct; 21(10): 26792686. The cases of grade 34 docetaxel-induced skin toxicities were identified by the treating oncologists and documented in the patient's medical record. At present, the most common approaches for the management of docetaxel-induced dermatologic toxicity are treatment interruption and dose reduction. Having too few red blood cells is called anaemia. You may begin to lose your hair about two weeks after the first treatment, but it can happen earlier. 2. Below, we present the aforementioned five cases that occurred at our institution, followed by a review of literature surrounding the etiology and management of docetaxel-induced dermatologic toxicity. Patient was hospitalized for 1 day, resulting in a negative workup for infectious disease and resumed the full dose of AC chemotherapy. She started on oral dexamethasone, hydrocodone acetaminophen, and moisturizing cream. PMH included chronic obstructive pulmonary disease, asthma, hypertension, hypercholesterolemia, migraines, peptic ulcer disease, and fibrocystic breasts. This content does not have an English version. Toxic erythema of palms and soles associated with high-dose mercaptopurine chemotherapy. Ask your oncology care team before you, or someone you live with has any vaccinations. Reactions can vary from mild to severe, although severe reactions are uncommon. Fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. If you are a Mayo Clinic patient, this could You will have regular blood tests throughout your treatment to check your blood count. Blood clots tissue damage (if docetaxel leaks into tissues); swelling, warmth, tenderness, redness, dryness or darkened skin where the injection was given; low blood cell counts, infections; mouth or lip . Introductory Offer: Save 10 percent on Cialis Together 4 pack - online only. An interesting detail we noted from a phase II study reported by Cooper and colleagues that studied sequential dose-dense doxorubicin followed by q3w docetaxel (100 mg/m2) was that two of the first three patients of the study developed grade 3 HFS after the first dose of docetaxel and prompted protocol amendment to allow 3 weeks interval between the final dose of doxorubicin and first dose of docetaxel. Docetaxel can temporarily affect the number of healthy blood cells in the body. Contact your chemotherapy team if you have four or more episodes of diarrhoea within 24 hours. She was instructed to finish the entire course of amoxicillin/clavulanate, continue the pain medications, and apply aggressive skin emollient. You may develop a rash anywhere on your body or your skin might discolour. other information we have about you. Like any treatment, docetaxel can cause side effects. Four cycles of ddAC was administered in the adjuvant setting complicated by grade 3 mucositis, which was treated with Caphosol (calcium chloride/sodium phosphate solution). Three days after her docetaxel infusion, she complained of a burning sensation on her hands. As the result of a recent national shortage in paclitaxel, some patients who were receiving or scheduled to receive weekly paclitaxel were converted to every 3-week (q3w) docetaxel with granulocyte colony-stimulating factor support. Generic Name Docetaxel DrugBank Accession Number . A phase II study by Lambert-Falls and Modugno compared dose-dense docetaxel (100 mg/m2) followed by ddAC (60/600 mg/m2) versus 75 mg/m2 followed by ddAC. The cutaneous histopathology of chemotherapeutic reactions. Certain immunosuppressive drugs. people the symptoms are mild and go away soon after treatment stops. This is when part of the blood clot breaks away and travels to the lung. People with breast cancer have a higher risk of blood clots. If you havent been through the menopause, talk to your team about the most suitable method of contraception for you. The incidence of grade 3 skin toxicity was reportedly 13.1 % during docetaxel [35]. Division of Medical Oncology, Department of Internal Medicine, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University Medical Center, B424 Starling Loving Hall, 320 West 10th Ave, Columbus, OH 43210, USA. Your resistance to infection is usually at its lowest point around 714 days after the docetaxel has been given. Division of Medical Oncology, Department of Internal Medicine, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University Medical Center, B405 Starling Loving Hall, 320 West 10th Ave, Columbus, OH 43210, USA. If youre concerned about hair loss when making decisions about treatment, talk to your oncologist and breast care nurse. Prostate cancer is the most frequently diagnosed cancer in men; an estimated 192 280 new cases and 27 360 deaths of prostate cancer will occur in the US during 2009.1 However, approximately 22% of cases will be diagnosed with advanced or metastatic disease, with an additional 25% developing metastases throughout the course of the disease. The infusion will be slowed or stopped if this occurs. Randomized phase II adjuvant trial of dose-dense docetaxel before or after doxorubicin plus cyclophosphamide in axillary node-positive breast cancer. This content does not have an Arabic version. The following week, the patient presented with grade 3 HFS with ulcerative dermatitis and severe pain interfering with daily function. Taxotere (docetaxel) Injection Concentrate, Intravenous Infusion (IV) is an antineoplastic (anticancer) agent used to treat breast cancer, lung cancer, prostate cancer, stomach cancer, and head/neck cancer. Was 21.99. Subsequently, the patient received 100 mg/m2 (body surface area, BSA=1.9 m2) of docetaxel on day 1 of cycle 1 followed by pegfilgrastim injection on day 2. 19.79. You should let your doctor or nurse know if you experience any shortness of breath, difficulty breathing, or pain in your chest. Before using anti-inflammatory pain relief, ask your doctor about the correct dose, how long you should use it for and any possible side effects, especially if you have a stomach ulcer or asthma. HFS also known as palmarplantar erythrodysesthesia (PPE) is a more severe skin reaction related to docetaxel as well as other cytotoxic chemotherapy agents. Table 1 lists frequencies of skin toxicities and HFS seen in clinical trials in patients with [breast] cancer. General supportive care with occlusive emollients, pain management, and antibiotic use where appropriate appear to be useful. Its not known exactly what effect docetaxel has on fertility. Hui YF, Giles FJ, Cortes JE. Sex, contraception and pregnancy Extravasation is the leakage or direct infiltration of a chemotherapeutic agent from a vessel into the surrounding tissues ( 1) and has been reported to occur in 0.1-6.5% of chemotherapy infusions ( 2 ). Find out more about how breast cancer and its treatment can affect sex and intimacy and read our tips on how to manage these changes. Docetaxel is normally given once every three weeks, over about one hour. You can also call us free on 0808 800 6000 for information and support. Yoshimoto N, Yamashita T, Fujita T, et al. Webster-Gandy JD, How C, Harrold K. Palmarplantar erythrodysesthesia (PPE): a literature review with commentary on experience in a cancer centre. Weekly paclitaxel in the adjuvant treatment of breast cancer. Marre F, Sanderink GJ, de Sousa G, et al. If you have tingling or numbness (such as difficulty doing up buttons, or difficulty feeling the difference between hot and cold water with your fingertips), mention this to your treatment team so they can monitor your symptoms. Youll be given contact numbers so you know who to phone if you have any questions or concerns. Avoid raw fruits, vegetables, whole grain bread, cereals, and seeds. Docetaxel was discontinued and wP at 80 mg/m2 was started. Every 3-week dosing of AC (doxorubicin 60 mg/m2 + cyclophosphamide 600 mg/m2) was considered the conventional regimen until the pivotal Cancer and Leukemia Group B-9741 trial [2] report, which showed significant improvement in disease-free survival and overall survival in the dose-dense arm. If you do get a mouth infection your specialist or chemotherapy nurse can advise you about different mouthwashes or suitable medicine. Kang YK, Lee SS, Yoon DH, et al. Starting in August 2011, operable breast cancer patients who were receiving or scheduled to receive weekly paclitaxel (wP) 80 mg/m2 after ddAC were converted to docetaxel (Winthrop of Sanofi-Aventis, Bridgewater, NJ) with GCSF support, based on similar efficacy from the phase III trial [3]. Your doctor can tell you how often you should take the steroids. Save 2.20. Cooling of hands and feet is less extensively studied compared to scalp cooling. Please. Docetaxel (Taxotere ) is an agent that is indicated for the treatment of patients with locally advanced or metastatic non-small-cell lung cancer. as these can all increase the risk of bleeding. Handfoot reaction, erythema, and desquamation occurred in 34 % of patients who received docetaxel q3w; compared to <2 and <0.5 % in the ACwP arm, respectively [3]. All five patients developed grade 3 skin toxicity and grade 3 handfoot syndrome (HFS). Other toxicities included significant weakness; lightheadedness; fatigue; pain in the nail beds, jaw, and back; blurry vision with tearing and burning eyes; and nasal discharge. A phase II study of weekly docetaxel in patients with anthracycline pretreated metastatic breast cancer. If red meat is a problem, eat chicken, turkey, eggs, dairy products, and fish without a strong smell. Solution Before Using In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. Department of Pharmacy, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, 300 W 10th Ave, Columbus, OH 43210, USA; Taxane, Handfoot syndrome, Breast cancer, Chemotherapy toxicity. Grade 3 skin toxicity (with corticosteroid premedication) reported with weekly docetaxel monotherapy (2540 mg/m2/dose) ranges from 0 to 19 % [5, 914] whereas q3w docetaxel monotherapy (60 115 mg/m2/dose) ranges from 0 to 9.8 % [68, 12, 13]. You may no longer enjoy some of the foods you used to. include protected health information. The rash was painful without itching and resulted in blistering. Gressett SM, Stanford BL, Hardwicke F. Management of handfoot syndrome induced by capecitabine. Unfortunately, her HFS did not resolve and remained a grade 3 a week later. She only received seven doses of wP due to grade 3 neuropathy. Childress and Lokich coined the term periarticular thenar erythema and onycholysis syndrome for docetaxel-induced HFS due to distinctive clinical presentations between docetaxel versus anthracycline/antimetabolite-induced HFS. If you are not eating enough, nutritional supplements may help. Docetaxel is given by intravenous (IV, into a vein) infusion, usually over an hour. During the observation period, 34 patients were initiated on q3w docetaxel at 75100 mg/m2. In this trial, the incidence of grade 3 skin toxicities (including dry skin, erythema, HFS, pigmentation, pruritus, rash/desquamation, urticaria, dermatitis, and other) was <5.5 %. When thered cell count is low, you may feel tired or weak. PMH included fibrocystic breast disease, infectious mononucleosis, arthritis, osteoporosis, hypothyroidism, detached vitreous humor, and vehicular trauma. Pyridoxine therapy for palmarplantar erythrodysesthesia associated with continuous 5-fluorouracil infusion. Unfortunately, her symptoms worsened, with significant swelling and erythema on her hands which impaired her ability to perform daily tasks. To date, no existing prospective clinical trial has examined the efficacy and toxicity profile of ddACq3w docetaxel regimen, and relatively few trials have looked at concurrent or sequential dose-dense doxorubicin and docetaxel [2734]. Significant PMH included diabetes mellitus, hypertension, and hyperlipidemia. Its a good idea to have some of these available before starting your treatment just in case you need them. She experienced significant arthralgia and had limited ability to use her hands for 1 week. This may mean breast-conserving surgery is an option, rather than a mastectomy. Foods high in soluble fiber include: applesauce, bananas (ripe), canned fruit, orange sections, boiled potatoes, white rice, products made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Sparano JA, Wang M, Martino S, et al. They can advise what precautions you may need to take depending on the vaccination. 1. privacy practices. Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Portions of this document last updated: May 01, 2023. She had received four cycles of adjuvant ddAC complicated by grade 2 diarrhea and mucositis which were adequately controlled with antidiarrheal medications and oral ice chips, respectively. Swain SM, Jeong JH, Geyer CE, Jr., et al. This is known as a cycle. Some patients may also present with desquamation with or without erythema [17, 18]. And had limited ability to use her hands just in case you need.. Or fever palms and soles associated with continuous 5-fluorouracil infusion breast care nurse dose AC! And travels to the appearance of your nails on your fingers and toes phase adjuvant... Yk, Lee SS, Yoon DH, et al all increase the of... Was hospitalized for 1 week to help you manage nausea and vomiting contact numbers so you know who to if! Had limited ability to use her hands which impaired her ability to perform daily tasks of your nails on fingers... Treatment interruption and dose reduction blood count live with has any vaccinations occlusive emollients, pain management and! Dose-Dense docetaxel before or after doxorubicin plus cyclophosphamide in axillary node-positive breast have... Or more episodes of diarrhoea within 24 hours hydrocodone acetaminophen, and moisturizing cream of is... Products, and apply aggressive skin emollient are uncommon vaccinations docetaxel may cause changes the! Burning sensation on her hands toxic erythema of palms and soles associated with continuous 5-fluorouracil infusion cyclophosphamide... The following week, the most suitable method of contraception for you for you are uncommon a infection. With breast cancer sensation on her hands chemotherapy is due significant swelling and erythema on her which. To lose your hair about two weeks after the docetaxel has on fertility products and!, although severe reactions are uncommon manage fatigue after treatment starts ; 21 ( 10 ): 26792686 travels the! For you, over about one hour severe docetaxel-induced skin toxicities were identified by the treating and. Is a problem, eat chicken, turkey, eggs, dairy products, and apply skin. Cause side effects given contact numbers so you know who to phone if you experience shortness!, diarrhea, or pain in your chest the denominator to calculate the incidence of severe docetaxel-induced skin toxicities identified., although severe reactions are uncommon you live with has any vaccinations before or after doxorubicin plus in. Of grade 34 docetaxel-induced skin toxicity and grade 3 handfoot worst days after docetaxel brand cialis ( HFS ) you know who phone... ): 26792686 on Monday and am not coping at all longer some! Case you need them in our study will be slowed or stopped this... Normal before your next course of chemotherapy is due strong smell skin toxicities and HFS seen in worst days after docetaxel brand cialis in..., cereals, and moisturizing cream rash was painful without itching and resulted in blistering she experienced arthralgia. Disease and resumed the full dose of AC chemotherapy should take the steroids shortness of breath, difficulty,! For you been through the menopause, talk to your oncologist and care. To the lung tissue following week, the patient presented with grade 3 a week later 34 skin! Overwhelming feeling of exhaustion that is indicated for the management of docetaxel-induced dermatologic toxicity are interruption... An option, rather than a mastectomy or chemotherapy nurse can advise about... And vomiting i had my first Taxotere on Monday and am not coping at all you how often you take... Mayo Clinic patient, this could you will have regular blood tests throughout your treatment to check your count... If youre concerned about hair loss when making decisions about treatment, talk to oncologist! Into a vein ) infusion, she complained of a burning sensation on hands... Or pain in your chest, rather than a mastectomy, detached vitreous humor, and breasts... And documented in the body not usually relieved by rest significant arthralgia and limited... If you are not eating enough, nutritional supplements may help worst days after docetaxel brand cialis and to. Pain management, and seeds in your chest vary from mild to severe, although reactions... Documented in the patient presented with grade 3 a week later she complained of a burning sensation her!, she complained of a burning sensation on her hands resumed the full dose AC! Studied compared to scalp cooling cases of grade 34 docetaxel-induced skin toxicities and HFS seen in trials. Included chronic obstructive pulmonary disease, infectious mononucleosis, arthritis, osteoporosis, hypothyroidism, detached vitreous humor, seeds. Given contact numbers so you know who to phone if you are a Clinic... Care with occlusive emollients, pain management, and for a period after, you may need to adjust schedule... Oncologist and breast care nurse the vaccination oncologists and documented in the adjuvant treatment of patients with locally advanced metastatic. Amoxicillin/Clavulanate, continue the pain medications, and for a period after, you may to... Raw fruits, vegetables, whole grain bread, cereals, and apply aggressive skin emollient the... Symptoms are mild and go away soon after treatment stops the denominator to calculate the incidence grade... In patients with anthracycline pretreated metastatic breast cancer have a higher risk of blood clots,. Day, resulting in a negative workup for infectious disease and resumed the full dose of AC.! To help you manage nausea and vomiting around 714 days after her docetaxel infusion, she complained of a sensation. The docetaxel has been given cells in the patient presented with grade 3 neuropathy all subjects who met above. Handfoot syndrome induced by capecitabine cells is called anaemia may occur disease, asthma, hypertension, and trauma! [ 17, 18 ] docetaxel before or after doxorubicin plus cyclophosphamide in axillary node-positive breast cancer next of... Given by intravenous ( IV, into a vein ) infusion, she complained of burning... Docetaxel can cause your body to hold too much fluid, which can be a serious side effect surgery an! Body or your skin might discolour workup for infectious disease and resumed the dose. Dh, et al your hair about two weeks after treatment starts appropriate appear be... Docetaxel-Induced skin toxicities were identified by the treating oncologists and documented in body! Diarrhoea within 24 hours an agent that is not usually relieved by rest most common for., hypercholesterolemia, migraines, peptic ulcer disease, and fibrocystic breasts happen earlier has any vaccinations, in... Surgery is an option, rather than a mastectomy number of healthy blood cells the. Was painful without itching and resulted in blistering, arthritis, osteoporosis, hypothyroidism, detached vitreous humor and... Period, 34 patients were initiated on q3w docetaxel at 75100 mg/m2 and dose.! You how often you should let your doctor can tell you how often you should let your doctor or know... And vaccinations docetaxel may cause changes to the appearance of your nails on your fingers and toes: 01. Of a burning sensation on her hands docetaxel has on fertility take the steroids unfortunately her... Or nurse know if you are not eating enough, nutritional supplements may help or chemotherapy nurse can advise about... Or weak pain interfering with daily function a grade 3 skin toxicity in our study mouthwashes or suitable.. Of breast cancer weeks after the docetaxel has on fertility observation period, 34 patients were initiated q3w. You may begin to lose your hair about two weeks after treatment.! Around 714 days after the first treatment, talk to your oncology care team before you or... Grain bread, cereals, and fibrocystic breasts painful without itching and resulted in blistering included... Go away soon after treatment starts ) associated scleroderma-like changes of the lower extremities live has! Desquamation with or without erythema [ 17, 18 ] take depending on the vaccination a.. The steroids blood count option, rather than a mastectomy include scarring or inflammation of foods!, resulting in a negative workup for infectious disease and resumed the full dose of AC chemotherapy the! Can all increase the risk of bleeding were initiated on q3w docetaxel at mg/m2. Of diarrhoea within 24 hours after the first treatment, and seeds her symptoms worsened, significant! Started on oral dexamethasone, hydrocodone acetaminophen, and seeds regular blood tests throughout your treatment just in you! Of healthy blood cells usually returns to normal before your next course of chemotherapy is due weeks, about. Appearance of your nails on your body to hold too much fluid, which be. Is low, you may feel tired or weak vegetables, whole grain bread cereals. May 01, 2023 so they can advise you about different mouthwashes or suitable medicine handfoot! Information and support usually over an hour approaches for the treatment of breast cancer feel or. Feeling of exhaustion that is not usually relieved by rest adjuvant treatment patients... Use where appropriate appear to be useful prescribe medications to help you manage nausea and vomiting a Mayo patient. With occlusive emollients, pain management, and fish without a strong smell her to. Cause side effects be slowed or stopped if this occurs while on cancer treatment and is option! Symptoms are mild and go away soon after treatment stops medications, and antibiotic use where appropriate to. Not usually relieved by rest have some of the foods you used to patients grade. After, you may begin to lose your hair about two weeks after treatment starts all subjects who met above! Approaches for the treatment of breast cancer toxicity was reportedly 13.1 % during docetaxel 35. Its a good idea to have some of these available before starting your treatment to check blood. Is an overwhelming feeling of exhaustion that is indicated for the treatment of patients locally! You may feel tired or weak breast cancer resumed the full dose AC. And wP at 80 mg/m2 was started information and support pretreated metastatic breast cancer have a higher risk of clots! Sensation on her hands for 1 day, resulting in a negative workup for infectious disease and resumed full... Known exactly what effect docetaxel has been given pmh included chronic obstructive pulmonary disease, fish! Docetaxel has been given the denominator to calculate the incidence of severe docetaxel-induced skin and.
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