RADIATION RECALL DERMATITIS AND PNEUMONITIS IN A PATIENT TREATED WITHPACLITAXEL

Background. Radiation recall refers to a tissue reaction produced by a chemotherapeutic agent in a previously irradiated field that would no t occur in a nonirradiated field. A number of agents have been reporte d to cause radiation recall. Recently, there have been case reports of recall dermatitis from paclitaxel treatment. Methods. A patient with metastatic lung cancer received palliative radiation to her mediastinu m and ribs. Because of disease progression, she subsequently received paclitaxel. Results. After paclitaxel administration, the patient beca me acutely dyspneic. A subsequent chest X-ray revealed a parenchymal o pacity in a region that corresponded with the patient's radiation port al. She also developed a severe skin reaction in the previously treate d electron field. Conclusions. This is one of few reported cases of re call dermatitis from paclitaxel and is also suggestive of recall pneum onitis, a phenomenon previously unreported to the authors' knowledge. Given paclitaxel's ability to function as a radiosensitizer, this resp onse is not unexpected. As the frequency of paclitaxel administration increases, its potential as a radiation sensitizer and radiation recal l should be considered.