title: [Porphyria and radiotherapy: yet a constellation of risk?].
abstract: BACKGROUND
  Little is known concerning the relation of porphyrias to radiation treatment for cancer. The recent literature does not report negative outcomes at least in single cases of breast cancer, bladder cancer or in a patient with lymphoma. Theoretically, there is a risk for radiation treatment in cases of porphyrias.
  
  
  METHODS
  Two patients with porphyria are described who underwent radiotherapy for glioblastoma multiforme. Case histories, radiation treatment data and the proof of porphyria are given in detail. The patients received a concomitant radiochemotherapy with infusions of ACNU [1-(4-amino-2-methyl-5-pyrimidinyl)-methyl-(2-chloroethyl)-3-nitrosourea] every 6 weeks. The total radiation doses at the ICRU point were 60 and 38 Gy, respectively, given in single daily fractions of 2 Gy.
  
  
  RESULTS
  Both patients responded well as far as objective tumor regression is concerned but died early after 7 and 1.5 months following diagnosis. The first patient experienced a large brain necrosis and deterioration of her porphyria. The second patient died of cardiopulmonary insufficiency still during radiotherapy with persistent or even increased signs of porphyria. The tumor showed extensive necrosis already after 38 Gy.
  
  
  CONCLUSIONS
  In view of annotations in the literature and this case report, caution is advised as for irradiation of brain or nervous tissues in case of porphyrias. Molecular biology data seems to support this warning to some extent.
authors.affiliation: Abteilung für Radioonkologie, Landeskrankenhaus, Feldkirch, Osterreich.
authors.forename: Walter
authors.initials: W
authors.lastname: Rhomberg
authors.forename: Felix Albert
authors.initials: FA
authors.lastname: Offner
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy*; D005260:Female; D005909:Glioblastoma / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011164:Porphyrias / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D011878:Radiotherapy / Q000009:adverse effects*; D018570:Risk Assessment; D016896:Treatment Outcome