pazopanib and Radiodermatitis

Topics: Administration, Oral; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Combined Modality Therapy; Diagnosis, Differential; Femoral Neoplasms; Fracture Fixation, Intramedullary; Fractures, Spontaneous; Humans; Imidazoles; Indazoles; Lung Neoplasms; Male; Middle Aged; Oximes; Pyrimidines; Radiodermatitis; Radiotherapy, Adjuvant; Sulfonamides

Topics: Acute Kidney Injury; Hair; Humans; Kidney Neoplasms; Radiodermatitis

Radiation recall reaction is an acute inflammatory reaction confined to previously irradiated areas that are most commonly triggered by the administration of anti-cancer agents after radiotherapy. Radiation recall myositis is a relatively rare form of radiation recall reaction.. Here we report a 29-year-old female patient who suffered from metastatic monophasic synovial sarcoma. 8.5 months after post-operative radiotherapy of the right thigh region, the patient suffered pain, edema, redness, and increased temperature locally on the right thigh. Physical exam showed red fixed skin, rigidity and severe tenderness of region, and thigh magnetic resonance imaging revealed dense edema areas at the addiction, semimembranous-semitendinous muscle, and superior part of the biceps femoris and vastus lateralis isointense on T1AG, hyperintense T2AG images. Based on these findings, the patient was diagnosed with pazopanib-induced radiation recall myositis.. Pazopanib was stopped and pentoxifylline (2  × 400 mg), Vitamin E (3  × 400 mg), and methylprednisolone (2  × 8 mg) were prescribed. After 1 month, complete relief of thigh pain and marked recovery of rigidity, as well as erythema, were achieved and no recurrence of radiation recall reaction-related symptoms was observed after the pazopanib rechallenge.. Myositis is a relatively rare presentation of radiation recall reaction and physicians must be aware of the symptoms of the patients who are treated by radiotherapy and pazopanib.

Topics: Adult; Female; Humans; Myositis; Pain; Radiodermatitis; Sarcoma

Pazopanib is a multi-targeted tyrosine kinase inhibitor that has recently been approved for treatment of advanced clear cell renal cell carcinoma (RCC). There are no previous reports of pazopanib triggering radiation recall dermatitis (RRD).. A 60-year-old male patient was commenced on pazopanib for metastatic RCC 2 weeks prior to receiving radiotherapy (10×30 Gy) to bone metastases at the T9 and L4 vertebrae and right mid-shaft of humerus. Although there were no immediate complications from radiotherapy, 2 weeks after finishing radiation he developed a pruritic, erythematous, maculo-papular rash localized to the T9 and right humeral radiotherapy fields. The patient was diagnosed with RRD induced by pazopanib and commenced on a course of oral prednisolone, which resulted in resolution of his rash. He has now completed 5 months of pazopanib with no recurrence of RRD.. We report the first case of RRD triggered by pazopanib. With increasing use of pazopanib for advanced RCC, clinicians must be aware of the possibility that RRD can occur in patients treated with this agent following radiotherapy.

Topics: Carcinoma, Renal Cell; Chemotherapy, Adjuvant; Combined Modality Therapy; Humans; Indazoles; Kidney Neoplasms; Male; Middle Aged; Pyrimidines; Radiodermatitis; Radiotherapy, Conformal; Sulfonamides; Treatment Outcome