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Sorafenib-triggered radiation recall dermatitis with a disseminated exanthematous reaction
오동렬,박희철,임호영,유병철 대한방사선종양학회 2013 Radiation Oncology Journal Vol.31 No.3
Sorafenib is a multi-targeted kinase inhibitor, which is the current standard treatment for advanced hepatocellular carcinoma (HCC). Only one case of radiation recall dermatitis (RRD) associated with sorafenib has been reported so far. Our patient with recurrent HCC was treated with palliative radiotherapy (RT) for the chest wall mass. Sorafenib at 400 mg twice daily was begun on the day following RT. On the 14th day post-RT, an erythematous patch was observed on right chest wall which matched area previously irradiated. It was consistent with RRD. Ten days later, a disseminated exanthematous rash and severe pruritus occurred. Sorafenib was stopped and an oral antihistamine was prescribed to relieve symptoms. At the 1-week follow-up after the cessation of sorafenib, all symptoms were resolved. Physicians should be alert to this recall phenomenon as it can occur both in the skin and elsewhere and the occurrence of RRD may be unpredictable.
Insufficiency fracture after radiation therapy
오동렬,허승재 대한방사선종양학회 2014 Radiation Oncology Journal Vol.32 No.4
Insufficiency fracture occurs when normal or physiological stress applied to weakened bone with demineralization and decreased elastic resistance. Recently, many studies reported the development of IF after radiation therapy (RT) in gynecological cancer, prostate cancer, anal cancer and rectal cancer. The RT-induced insufficiency fracture is a common complication during the follow-up using modern imaging studies. The clinical suspicion and knowledge the characteristic imaging patterns of insufficiency fracture is essential to differentiate it from metastatic bone lesions, because it sometimes cause severe pain, and it may be confused with bone metastasis.
오동렬,신성욱,박희철,조성기,임도훈,백승운 대한암학회 2015 Cancer Research and Treatment Vol.47 No.2
Purpose In this study, we retrospectively investigated the prevalence of arterioportal (AP) shunts inhepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) andevaluated the changes in AP shunts after chemoembolization followed by external beamradiation therapy (EBRT). Materials and MethodsWe analyzed 54 HCC patients with PVTT who were treated with chemoembolization followedby EBRT. EBRT was uniformly delivered at a total dose of 30 to 45 Gy (median, 35 Gy), witha daily dose of 2 to 4.5 Gy. Angiographic images of chemoembolization before and afterradiation therapy (RT) were reviewed to investigate the AP shunt. ResultsDuring the initial session of chemoembolization, 33 of 54 patients (61%) had an AP shunt. After EBRT, 32 out of 33 patients had an additional session of chemoembolization and wereevaluated for a change in the AP shunt. The AP shunt decreased in 20 of 32 patients (63%)after chemoembolization followed by EBRT. The 1-year calculated overall survival (OS) ratefor all patients was 52.6% and the 2-year OS was 36.4%. The median OS in all patients was13 months. Patients with AP shunt showed poorer median OS than those without AP shunt,but there was no statistically significant difference (median, 12 months vs. 17 months). ConclusionThe AP shunt frequently occurs in HCC patients with PVTT. This study suggests that a poorprognosis is associated with an AP shunt. Chemoembolization followed by RT may producea decrease in AP shunts.