Safe span of time to take Chemotherapy after finishing Radiotherapy.

I have CA Breast Rt. got BCS (22nd Mar, 02), 1-3 Cycles of adjuvant Chemotherapy of CEF Regimen between 5th April,02 to 17th May,02 at 21 days interval. Got Radiotherapy with LINAC 2100D @ 1.8 GY/Fractions total 25 Fractions i. e. total 45 Gy from 7th June-13th July,02, and now scheduled to receive 10Gy/One Fraction with HDR Implant on 23rd July, 02. Already I have some blisters and mild pain in the Radiation area, getting treated with local applications and pain relievers at times. My Medical Oncologist putting me to a plan to take the 4th-6 Cycles of same Chemotherapeutic Drugs (CEF) starting from 25th July, 2002 at 21 days interval.

Since I am taking Chemo Drug, Epirubicin (Anthracycline based), Chemotherapy could not be continued during Radiotherapy, I understand to secure me from adverse reaction on my skin. In my present condition and if pathologically I am OK, then should I start the 4th Cycle of Chemotherapy on 25th July,02 as advised ?

Your valuable advise is solicited, as I am deeply concerned.

[CCF-RN,MSN-JS]

Dear Afroza, The decision when to resume chemotherapy depends on a few factors such as the treatment protocol timeframe and when your body is sufficiently recuperated from certain side effects such as low blood counts.  They may want to check your blood count before starting chemo.  You will want to make sure the oncologist is aware of the blistering at the radiation site,
they will want to check the area of radiation, that the blistering is showing signs of healing.  When chemotherapy resumes epirubicin can cause what is referred to as radiation recall, the area of the radiation can appear more inflamed.  Overall the correct time to start chemotherapy after radiation is best determined by the radiation oncologist and the medical oncologist.