Paclitaxel-carboplatin induced radiation recall colitis.
Some chemotherapeutic agents can "recall" the irradiated volumes by skin or pulmonary reactions in cancer patients who previously received radiation therapy. We report a recall colitis following the administration of paclitaxel-containing regimen in a patient who had been irradiated for a carcinoma of the uterine cervix. A 63-year-old woman underwent a Wertheim operation because of uterine cervix carcinoma. After 8 years of follow-up, a local recurrence was observed and she received curative external radiotherapy (45 Gy) to the pelvis. No significant adverse events were observed during the radiotherapy. Approximately one year later, she was hospitalized because of metastatic disease with multiple pulmonary nodules, and a chemotherapy regimen consisting of paclitaxel and carboplatin was administered. The day after the administration of chemotherapy the patient had diarrhea and rectal bleeding. Histological examination of the biopsy taken from rectal hyperemic lesions showed a radiation colitis. The symptoms reappeared after the administration of each course of chemotherapy and continued until the death of the patient despite the interruption of the chemotherapy. In conclusion, the probability of recall phenomena should be kept in mind in patients who received previously with pelvic radiotherapy and treated later with cytotoxic chemotherapy.
Kundak
Isil
I
Department of Hematology-Oncology, Faculty of Medicine, University of Dokuz Eylul, Izmir, Turkey. isil.kundak@deu.edu.tr
Oztop
Ilhan
I
Soyturk
Mujde
M
Ozcan
Mehmet Ali
MA
Yilmaz
Ugur
U
Meydan
Nezih
N
Gorken
Ilknur Bilkay
IB
Kupelioglu
Ali
A
Alakavuklar
Mehmet
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D016190:Carboplatin / Q000009:adverse effects; D002277:Carcinoma / Q000532:radiotherapy* / Q000601:surgery; D003967:Diarrhea / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D017239:Paclitaxel / Q000009:adverse effects; D011349:Proctitis / Q000139:chemically induced / Q000209:etiology*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy* / Q000601:surgery
D016190:Carboplatin; D017239:Paclitaxel