Abstract | BACKGROUND: CASE REPORT: RESULTS: A 63-year-old female patient with stage IV NSCLC presented with 11 asymptomatic brain metastases and a painful osteolytic bone metastasis in the 12th thoracic vertebral body (T12). Four weeks before the start of palliative whole-brain radiotherapy and bone irradiation of T12, she was administered a combination of docetaxel and ramucirumab. At an administered dose of 24 Gy, the patient presented with severe folliculitis capitis, while skin examination over the thoracolumbar spine was unremarkable although skin dose was similar. After thorough questioning, the patient reported using a herbal skin oil that contained St. John's wort for scalp care only, but not for skin care of her back during radiotherapy. After stopping the topical application of the skin oil, folliculitis improved with a course of systemic and topical antibiotics within 10 days, though the healing process was prolonged and included desquamation and hyperpigmentation. CONCLUSION: St. John's wort seems to be a significant radiosensitizer for photon radiotherapy and can cause severe skin toxicity even though the literature lacks data on this interaction. As an OTC, it is easily accessible and often used by oncological patients due to antidepressant and local antimicrobial and pain-relieving effects.
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Authors | Tanja Eichkorn, Fabian Schunn, Sebastian Regnery, Rami El Shafie, Juliane Hörner-Rieber, Sebastian Adeberg, Klaus Herfarth, Jürgen Debus, Laila König |
Journal | Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
(Strahlenther Onkol)
Vol. 197
Issue 7
Pg. 644-649
(Jul 2021)
ISSN: 1439-099X [Electronic] Germany |
PMID | 33491130
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Antibodies, Monoclonal, Humanized
- Antineoplastic Agents
- Phytochemicals
- Docetaxel
- ramucirumab
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Topics |
- Antibodies, Monoclonal, Humanized
(therapeutic use)
- Antineoplastic Agents
(therapeutic use)
- Bone Neoplasms
(radiotherapy, secondary)
- Brain Neoplasms
(radiotherapy)
- Carcinoma, Non-Small-Cell Lung
(drug therapy, pathology)
- Docetaxel
(therapeutic use)
- Female
- Humans
- Hypericum
(chemistry)
- Lung Neoplasms
(drug therapy, pathology)
- Middle Aged
- Phytochemicals
(chemistry, therapeutic use)
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