Barlési Fabrice, Tummino Céline, Tasei Anne-Marie, Astoul Philippe
Faculty of Medicine, Université de la Méditerranée, Department of Thoracic Oncology, Respiratory Diseases Division, Hôpital Sainte-Marguerite, Marseille Cedex 09, France.
Lung Cancer. 2006 Dec;54(3):423-5. doi: 10.1016/j.lungcan.2006.06.021. Epub 2006 Oct 17.
Radiation recall dermatitis is characterized by an inflammatory reaction within a previously irradiated volume after administration of a drug. Antineoplastic drugs have mainly been involved in radiation recall reactions. This phenomenon is well known but poorly understood. Many hypotheses as stem-cell depletion in the radiotherapy field, heritable mutations within surviving stem cells, local vascular changes as well as a drug hypersensitivity reaction have been proposed to explain these reactions. In this report, we describe a non-small cell lung cancer patient treated with a carboplatin plus gemcitabine combination chemotherapy as first line followed by pemetrexed as second line therapy. Twenty-five years ago, she completed radiation therapy for breast cancer. Three days after the first cycle of pemetrexed, she presented with a radiation recall dermatitis. As EGFR-staining was negative, we rechallenged the patient with pemetrexed. Unfortunately, although less intense, we faced a recurrence of the skin reaction and pemetrexed was no longer continued.
放射性回忆性皮炎的特征是在给予药物后，先前接受过放射治疗的区域内出现炎症反应。抗肿瘤药物主要与放射性回忆反应有关。这种现象虽广为人知，但了解甚少。人们提出了许多假说，如放疗领域的干细胞耗竭、存活干细胞内的遗传突变、局部血管变化以及药物过敏反应来解释这些反应。在本报告中，我们描述了一名非小细胞肺癌患者，一线接受卡铂加吉西他滨联合化疗，二线接受培美曲塞治疗。25年前，她完成了乳腺癌放疗。在培美曲塞第一个周期治疗三天后，她出现了放射性回忆性皮炎。由于表皮生长因子受体（EGFR）染色为阴性，我们让患者再次接受培美曲塞治疗。不幸的是，尽管症状较轻，但皮肤反应复发，培美曲塞不再继续使用。
