Breast conservation therapy. Severe breast fibrosis after radiation therapy in patients with collagen vascular disease

Robertson, John M.; Clarke, Daniel H.; Matter, Richard C.; Pevzner, Martin

doi:10.1002/1097-0142(19910801)68:3<502::aid-cncr2820680310>3.0.co;2-v

Cited by 125 publications

(40 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Early publications were largely case reports of CVD patients with increased toxicity from RT. [1][2][3][4][5][6][7][8] However, 2 separate matched control studies failed to observe any increased risk of acute or late complications in patients with CVD versus patients without CVD. 9,10 Other publications suggested that patients with nonrheumatoid arthritis CVD, 11,12 or patients with specific subtypes of CVD, may be at increased toxicity risk.…”

mentioning

confidence: 99%

Toxicity of radiotherapy in patients with collagen vascular disease

Lin

Abu-Isa

Griffith

et al. 2008

Cancer

105

View full text Add to dashboard Cite

BACKGROUND.A diagnosis of collagen vascular disease (CVD) may predispose to radiotherapy (RT) toxicity. The objective of the current study was to identify factors that influence RT toxicity in the setting of CVD.METHODS.A total of 86 RT courses for 73 patients with CVD were delivered between 1985 and 2005. CVD subtypes include rheumatoid arthritis (RA; 33 patients), systemic lupus erythematosus (SLE; 13 patients), scleroderma (9 patients), dermatomyositis/polymyositis (5 patients), ankylosing spondylitis (4 patients), polymyalgia rheumatica/temporal arteritis (4 patients), Wegener granulomatosis (3 patients), and mixed connective tissue disorders (MCTD)/other (2 patients). Each patient with CVD was matched to 1 to 3 controls with respect to sex, race, site irradiated, RT dose (±2 Gray), and age (±5 years).RESULTS.There was no significant difference between CVD patients (65.1%) and controls (72.5%) experiencing any acute toxicity. CVD patients had a higher incidence of any late toxicity (29.1% vs 14%; P = .001), and a trend toward an increased rate of severe late toxicity (9.3% vs 3.7%; P = .079). RT delivered to the breast had increased risk of severe acute toxicity, whereas RT to the pelvis had increased risk of severe acute and late toxicity. RT administered in the setting of scleroderma carried a higher risk of severe late toxicity, whereas RT to SLE patients carried a higher risk of severe acute and late toxicity.CONCLUSIONS.Although generally well tolerated, RT in the setting of CVD appears to carry a higher risk of late toxicity. RT to the pelvis or in the setting of SLE or scleroderma may predispose to an even greater risk of severe toxicity. These issues should be considered when deciding whether to offer RT for these patients. Cancer 2008. © 2008 American Cancer Society.

show abstract

mentioning

confidence: 99%

Toxicity of radiotherapy in patients with collagen vascular disease

Lin

Abu-Isa

Griffith

et al. 2008

Cancer

105

View full text Add to dashboard Cite

show abstract

“…[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Scleroderma is a vascular disease marked by fibrosis, similar to what is often observed in late radiation injury. In normal individuals (ie no autoimmune disease), radiation therapy has been reported to be the initiating event for development of localized scleroderma usually within the radiation port but also at sites distal to the radiation field.…”

Section: Treatment Of Scleroderma With Radiationmentioning

confidence: 99%

“…[22][23][24][25][26][27][28][29] In patients with scleroderma, numerous papers have reported severe radiation-induced toxicity. [30][31][32][33][34] When using high-dose (40-70 cGy) localized radiation to treat cancer in patients with scleroderma, radiation-related injury may extended beyond the radiation field and causes death in approximately a third of patients and/or severe fibrosis overlapping the radiation field in the survivors. Patients with scleroderma undergoing breast irradiation have a significant increase in radiation-related complications including arm edema, chest wall necrosis, brachial plexopathy, pneumonitis, severe cutaneous fibrosis with retractions, and fistulae.…”

Section: Treatment Of Scleroderma With Radiationmentioning

confidence: 99%

The rationale behind autologous autoimmune hematopoietic stem cell transplant conditioning regimens: concerns over the use of total-body irradiation in systemic sclerosis

Burt

Kallunian

Patel

et al. 2004

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:Hematopoietic stem cell transplantation (HSCT) is becoming an increasingly recognized indication for treatment of autoimmune diseases and severe immunemediated disorders. However, multicenter registry data have demonstrated higher than anticipated early toxicity, approximately 10% for autoimmune diseases in general, and 20-27% for diffuse systemic sclerosis (scleroderma). If uncorrected, this high treatment-related mortality will hinder development of stem cell therapy for immunemediated diseases. In order to develop safer regimens, we address some pitfalls and concepts involved in design and selection of conditioning regimens for autoimmune diseases in general, and because it is associated with the highest regimen-related toxicity, scleroderma in specific.

show abstract

“…The review of the literature documents no case of stenosis of the esophagus or trachea after radiotherapy of Castleman disease. However, autoimmune disorders such as systemic lupus erythematosus and scleroderma have been reported to be associated with an increased incidence of long term radiation sequelae involving the skin and soft tissues [24,25]. Late complications reported include severe fibrosis and/or necrosis of the skin, breast, bowel, and pelvis.…”

Section: Discussionmentioning

confidence: 99%