Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON.
Curr Oncol. 2010 Oct;17(5):70-3. doi: 10.3747/co.v17i5.593.
A 60-year-old woman with breast cancer metastatic to the bones experienced no adverse skin reaction at the lumbar spine after a single 8-Gy photon-beam fraction prescribed to a depth of 5 cm. However, a subsequent treatment to the thoracic spine using the same dose, fractionation, and technique resulted in skin erythema and permanent hyperpigmentation. After careful investigation, no differences were identified in her concurrent use of possibly radiosensitizing medications during the various radiotherapy treatments nor in possible errors of treatment planning and radiation delivery. To our knowledge, this is the first case report to document that, with similar medications, a previous skin response to a given radiotherapy dose, fraction, and technique may not be predictive of subsequent skin response to similar radiotherapy.
一位 60 岁的乳腺癌骨转移女性患者，在腰椎单次 8Gy 光子束照射（深度 5cm）后，未出现不良反应的皮肤反应。然而，随后采用相同剂量、分割和技术对胸椎进行治疗后，出现皮肤红斑和永久性色素沉着。经过仔细调查，在不同的放疗期间，她同时使用可能增加放疗敏感性的药物，以及治疗计划和放射治疗的实施，均未发现差异。据我们所知，这是首例报道，表明在使用类似药物的情况下，先前对特定放疗剂量、分割和技术的皮肤反应不一定能预测后续对类似放疗的皮肤反应。
