Interferon-gamma in 5 patients with cutaneous radiation syndrome after radiation therapy.
BACKGROUND
Irradiation can cause acute inflammatory responses as well as chronic fibrotic alterations of the skin. Cutaneous radiation fibrosis evokes a complex of therapeutic problems. However, therapeutic options, apart from surgical approaches, are limited.


METHODS
Five female patients suffering from severe cutaneous fibrosis were treated with interferon-gamma on a low-dose regimen, 3 x 100 microg/week subcutaneously for 6 months, then once per week for another 6 months. In 4 patients, skin thickness was measured with high-frequency (20 MHz) ultrasound in a clinically well-defined target skin lesion. In 1 patient, nuclear magnetic resonance imaging was performed to quantify the extent of cutaneous radiation fibrosis and to monitor the therapeutic outcome.


RESULTS
All patients suffered from radiation-induced cutaneous fibrosis. Additionally, in 1 patient, a fistula, as assessed by lymph vessel scintigraphy, and in another patient a radiation ulcer was diagnosed. In all patients, reduction of radiation-induced fibrosis could be documented. Both fistula and radiation ulcer regressed completely under interferon-gamma therapy.


CONCLUSIONS
Low-dose interferon-gamma therapy is a new and effective treatment modality for cutaneous radiation fibrosis caused by radiation therapy. The positive impact of interferon-gamma on our patients warrants randomized double-blind trials on therapy of radiation fibrosis.
Gottlöber
P
P
Department of Dermatology, University of Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany. Petra.Gottloeber@medizin.uni-ulm.de
Steinert
M
M
Bähren
W
W
Weber
L
L
Gerngross
H
H
Peter
R U
RU
D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy; D005260:Female; D005355:Fibrosis; D006801:Humans; D007371:Interferon-gamma / Q000627:therapeutic use*; D008875:Middle Aged; D011855:Radiodermatitis / Q000188:drug therapy* / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D012509:Sarcoma / Q000532:radiotherapy; D012512:Sarcoma, Ewing / Q000532:radiotherapy; D012867:Skin / Q000473:pathology / Q000528:radiation effects; D014860:Warts / Q000532:radiotherapy
D007371:Interferon-gamma