title: Lack of Cetuximab induced skin toxicity in a previously irradiated field: case report and review of the literature.
abstract: BACKGROUND
  Mutation, amplification or dysregulation of the EGFR family leads to uncontrolled division and predisposes to cancer. Inhibiting the EGFR represents a form of targeted cancer therapy.
  
  
  METHODS
  We report the case of 79 year old gentleman with a history of skin cancer involving the left ear who had radiation and surgical excision. He had presented with recurrent lymph node in the left upper neck. We treated him with radiation therapy concurrently with Cetuximab. He developed a skin rash over the face and neck area two weeks after starting Cetuximab, which however spared the previously irradiated area.
  
  
  CONCLUSIONS
  The etiology underlying the sparing of the previously irradiated skin maybe due to either decrease in the population of EGFR expressing cells or decrease in the EGFR expression. We raised the question that "Is it justifiable to use EGFR inhibitors for patients having recurrence in the previously irradiated field?" We may need further research to answer this question which may guide the physicians in choosing appropriate drug in this scenario.
authors.affiliation: Department of Radiation Oncology, University of Mississippi Medical Center, 350 W Woodrow Wilson Drive #1600, Jackson, MS 39213, USA. mkanakamedala@ci.umsmed.edu
authors.forename: Madhava R
authors.initials: MR
authors.lastname: Kanakamedala
authors.forename: Satyaseelan
authors.initials: S
authors.lastname: Packianathan
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Vijayakumar
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000494:pharmacology*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000494:pharmacology*; D000068818:Cetuximab; D003131:Combined Modality Therapy; D066246:ErbB Receptors / Q000037:antagonists & inhibitors* / Q000276:immunology / Q000378:metabolism; D005076:Exanthema / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011879:Radiotherapy Dosage; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; C512478:EGFR protein, human; D066246:ErbB Receptors; D000068818:Cetuximab