Myelopathy after radiation therapy and chemotherapy with capecitabine and gemcitabine.
This article describes a woman with metastatic upper gastrointestinal cancer who developed thoracic myelopathy unexpectedly after standard dosage and fractionation radiotherapy. She also was receiving capecitabine and gemcitabine concomitantly. There are few reported cases of chemotherapy potentiation of spinal cord radiation toxicity. These agents are known radiosensitizers, making it likely that they contributed to this adverse outcome. As these agents are increasingly incorporated into clinical trials of combined therapy, caution will be necessary in both trial design and clinical management.
Barstis
John L
JL
Division of Hematology-Oncology, Department of Medicine, UCLA School of Medicine, Los Angeles, California 90095, USA. jbarstis@mednet.ucla.edu
Black
Alexander C
AC
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D000069287:Capecitabine; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D008875:Middle Aged; D011832:Radiation Injuries; D011838:Radiation-Sensitizing Agents / Q000009:adverse effects; D013118:Spinal Cord Diseases / Q000209:etiology*; D000093542:Gemcitabine
D011838:Radiation-Sensitizing Agents; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil; D000093542:Gemcitabine