title: Significant fibrosis after radiation therapy in a patient with Marfan syndrome.
abstract: Marfan syndrome is one of the collagen vascular diseases that theoretically predisposes patients to excessive radiation-induced fibrosis yet there is minimal published literature regarding this clinical scenario. We present a patient with a history of Marfan syndrome requiring radiation for a diagnosis of a right brachial plexus malignant nerve sheath tumor. It has been suggested that plasma transforming growth factor beta 1 (TGF-β1) can be monitored as a predictor of subsequent fibrosis in this population of high risk patients. We therefore monitored the patient's TGF-β1 level during and after treatment. Despite maintaining stable levels of plasma TGF-β1, our patient still developed extensive fibrosis resulting in impaired range of motion. Our case reports presents a review of the literature of patients with Marfan syndrome requiring radiation therapy and the limitations of serum markers on predicting long-term toxicity.
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Suarez
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Knackstedt
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Jenrette
keywords: Fibrosis; Marfan syndrome; Radiation therapy; Transforming growth factor beta1