Tuberc Respir Dis.  2006 Aug;61(2):167-170.

Gemcitabine-Induced Radiation Recall Dermato-Myositis

• No HS
• Lim HH
• Kim JH
• Cho JH
• Huh JK
• Cho SI
• Yoo JY
• Kim CH
• Lee JC

Abstract

A radiation recall reaction refers to an inflammatory reaction at previous irradiated areas subsequent to the administration of a variety of pharmacological agents. The skin is the major site of radiation recall reactons with the muscle and internal organs being less commonly affected. These reactions usually occur days to weeks after exposure to the causative agents. We report a case of gemcitabine-induced radiation recall dermato-myositis the developed in a female patient with a metastatic non-small cell lung cancer. She had received a palliative radiation therapy of 3900 cGy to the metastatic lesion on the femur shaft prior to chemotherapy. The pain, swelling and erythema of the left thigh resolved after the cessation of gemcitabine and the use of a systemic steroid.

Keyword

Radiation recall; Gemcitabine; Lung cancer

MeSH Terms

Carcinoma, Non-Small-Cell Lung
Drug Therapy
Erythema
Female
Femur
Humans
Lung Neoplasms
Radiodermatitis
Skin
Thigh

Figure

• 

  Figure 1 Chest CT showing that reduced size of mass in RLL after the second-line chemotherapy with gemcitabine and vinorelbine

• 

  Figure 2 Simple X-ray of the femur showing osteolytic lesion in left proximal diaphysis.

• 

  Figure 3 A. Thigh MRI revealing the metastatic mass-like lesion in left proximal femur involving both medullary and cortical bone. B. Thigh MRI showing the homogenous enhancement of left thigh muscle and subcutaneous fat edema, which were in accord with the radiation field.

Reference

1. D'Angio GJ, Farber S, Maddock CL. Potentiation of X-ray effects of actinomycin D. Radiology. 1959. 73:175–177.

2. Schweitzer VG, Juillard GJ, Bajada CL, Parker RG. Radiation recall dermatitis and pneumonitis in a patient treated with paclitaxel. Cancer. 1995. 76:1069–1072.

3. Sears ME. Erythema in areas of previous irradiation in patients treated with hydroxyurea. Cancer Chemothrapy Rep. 1964. 40:31–32.

4. von Essen CF, Kligerman MM, Calabresi P. Radiation and 5-fluorouracil: a controlled clinical study. Radiology. 1963. 81:1018–1027.

5. Kennedy RD, McAleer JJ. Radiation recall dermatitis in a patient treated with dacarbazine. Clin Oncol. 2001. 13:470–472.

6. Thomas R, Stea B. Radiation recall dermatitis from high dose interferon alfa-2b. J Clin Oncol. 2002. 20:355–357.

7. Ortmann E, Hohenberg G. Radiation recall phenomenon after administration of carpecitabine. J Clin Oncol. 2002. 20:3029–3030.

8. Chan RT, Au GK, Ho JW, Chu KW. Radiation recall with oxaliplatin: report of a case and review of the literature. Clin Oncol. 2001. 13:55–57.

9. Burdon J, Bell R, Sullivan J, Henderson M. Adriamycin-induced radiation recall 15years after radiotherapy. JAMA. 1978. 239:931.

10. Bostrom A, Sjolin-Forsberg G, Wilking N, Bergh J. Radiation recall: another call with tamoxifen. Acta Oncol. 1999. 38:955–959.

11. Extermann M, Vogt N, Forni M, Dayer P. Radiation recall in a patient with breast cancer treated for tuberculosis. Eur J Ciln Pgarmacol. 1995. 48:77–78.

12. Friedlander PA, Bansal R, Schwartz L, Wagman R, Posner J, Kemeny N. Gemcitabine-related radiation recall preferentially involves internal tissue and organs. Cancer. 2004. 100:1793–1799.

13. Welsh JS, Torre TG, DeWeese TL, O'Reilly S. Radiation myositis. Ann Oncol. 1999. 10:1105–1108.

14. Vozenin-Brotons MC, Gault N, Sivan V, Tricaud Y, Dubray B, Clough K, et al. Histopathological and cellular studies of a case of cutaneous radiation syndrome after accidental chronic exposure to a cesium source. Radiat Res. 1999. 152:332–337.

15. Johnston CJ, Piedboeuf B, Rubin P, Williams JP, Baggs R, Finkelstein JN. Early and persisent altrations in the expression of interlukin-1 alpha, interlukin-1 beta and tumor necrosis factor alpha mRNA levels in fibrosis-resistant and sensitive mice after thoracic irradiation. Radiat Res. 1996. 145:762–767.