title: [Hypersensitivity to radiation therapy in a patient with tuberous sclerosis: biological considerations about a clinical case].
abstract: A 61-year-old man, with a tuberous sclerosis, experienced severe acute reactions during a concomitant chemoradiotherapy regimen after 22Gy and one cycle of 5-fluorouracil-cisplatinum. He was treated for a cervical squamous cell lymph node of unknown origin. Grade 3 mucitis and epitheliitis were observed only in the irradiated fields and required the end of the radiotherapy. Tuberous sclerosis is characterized by a loss of the TSC2 function, with a permanent activation of the mTOR pathway. Logically, some kind of "radioresistance" should be observed. Increased radiosensitivity is paradoxical. This case illustrates how radiosensitivity is a complex phenomenon and clinically unpredictable. Efficiency of the protocols associations of mTOR inhibitors and radiotherapy should be carefully scrutinized.
authors.affiliation: Service de cancérologie-radiothérapie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
authors.forename: B
authors.initials: B
authors.lastname: Duchemann
authors.forename: B
authors.initials: B
authors.lastname: Duchemain
authors.forename: S
authors.initials: S
authors.lastname: Wong
authors.forename: V
authors.initials: V
authors.lastname: Baruch-Hennequin
authors.forename: S
authors.initials: S
authors.lastname: Rivera
authors.forename: L
authors.initials: L
authors.lastname: Quero
authors.forename: C
authors.initials: C
authors.lastname: Hennequin
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D004941:Esophagitis / Q000209:etiology* / Q000235:genetics; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use; D014644:Genetic Variation; D006801:Humans; D008197:Lymph Node Excision; D015182:Lymphatic Irradiation / Q000009:adverse effects*; D008207:Lymphatic Metastasis / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009333:Neck; D009378:Neoplasms, Multiple Primary / Q000235:genetics; D009382:Neoplasms, Unknown Primary; D011832:Radiation Injuries / Q000209:etiology* / Q000235:genetics; D011836:Radiation Tolerance / Q000235:genetics / Q000502:physiology; D011855:Radiodermatitis / Q000209:etiology* / Q000235:genetics; D015398:Signal Transduction / Q000235:genetics; D058570:TOR Serine-Threonine Kinases / Q000502:physiology; D014402:Tuberous Sclerosis / Q000235:genetics / Q000503:physiopathology*; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins / Q000172:deficiency / Q000235:genetics
chemical_list: C000624653:TSC2 protein, human; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D002945:Cisplatin; D005472:Fluorouracil