Radiation recall skin toxicity with bleomycin in a patient with Kaposi sarcoma related to acquired immune deficiency syndrome.

Abstract

BACKGROUND:

Radiation recall is a recurrence of acute toxicity within a previously quiescent radiation field that occurs with subsequent administration of chemotherapy.

METHODS:

A patient with acquired immune deficiency syndrome (AIDS)-related Kaposi sarcoma (KS) who had radiation recall is reported. The patient was participating in a randomized prospective trial of radiation treatment regimens for KS. Each lesion was randomized to one of three possible radiation fractionation schemes. All lesions were photographed and measured before treatment with radiation.

RESULTS:

Two skin sites developed erythema and dry desquamation 18 days after completion of radiation therapy to a dose of 40 Gy in 20 fractions. These reactions took place after the second dose of bleomycin administered intravenously on a weekly basis. The reactions were exacerbated by oral etoposide therapy, which was started 4 days after the recall phenomenon was noted. Other cutaneous sites treated with 8 Gy in a single fraction and 20 Gy in ten fractions during the same time period showed no sign of recall skin toxicity.

CONCLUSIONS:

The authors believe this to be the first report of radiation recall toxicity after bleomycin therapy and of a radiation dose response related to this phenomenon. The potential for radiation recall toxicity should be considered in treatment decisions pertaining to patients with AIDS-associated KS.

• Authors: K J Stelzer, T W Griffin, W J Koh
• Journal: Cancer (Cancer) Vol. 71 Issue 4 Pg. 1322-5 (Feb 15 1993) ISSN: 0008-543X [Print] United States
• PMID: 7679610 (Publication Type: Case Reports, Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Bleomycin

Topics

• AIDS-Related Opportunistic Infections (drug therapy, radiotherapy)
• Adult
• Bleomycin (adverse effects, therapeutic use)
• Combined Modality Therapy
• Humans
• Male
• Mouth Neoplasms (drug therapy)
• Neoplasms, Multiple Primary (drug therapy, radiotherapy)
• Radiotherapy Dosage
• Radiotherapy, High-Energy
• Sarcoma, Kaposi (drug therapy, radiotherapy)
• Skin (drug effects, radiation effects)
• Skin Neoplasms (drug therapy, radiotherapy)