[Hypersensitivity to radiation therapy in a patient with tuberous sclerosis: biological considerations about a clinical case]

B Duchemann; S Wong; V Baruch-Hennequin; S Rivera; L Quero; C Hennequin

doi:10.1016/j.canrad.2012.11.001

[Hypersensitivity to radiation therapy in a patient with tuberous sclerosis: biological considerations about a clinical case]

Cancer Radiother. 2013 Feb;17(1):50-3. doi: 10.1016/j.canrad.2012.11.001. Epub 2012 Dec 25.

[Article in French]

Authors

B Duchemann¹, S Wong, V Baruch-Hennequin, S Rivera, L Quero, C Hennequin

Affiliation

¹ Service de cancérologie-radiothérapie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.

PMID: 23270679
DOI: 10.1016/j.canrad.2012.11.001

Abstract

A 61-year-old man, with a tuberous sclerosis, experienced severe acute reactions during a concomitant chemoradiotherapy regimen after 22Gy and one cycle of 5-fluorouracil-cisplatinum. He was treated for a cervical squamous cell lymph node of unknown origin. Grade 3 mucitis and epitheliitis were observed only in the irradiated fields and required the end of the radiotherapy. Tuberous sclerosis is characterized by a loss of the TSC2 function, with a permanent activation of the mTOR pathway. Logically, some kind of "radioresistance" should be observed. Increased radiosensitivity is paradoxical. This case illustrates how radiosensitivity is a complex phenomenon and clinically unpredictable. Efficiency of the protocols associations of mTOR inhibitors and radiotherapy should be carefully scrutinized.

Publication types

Case Reports

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / adverse effects
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Carcinoma, Squamous Cell / radiotherapy
Carcinoma, Squamous Cell / secondary*
Chemoradiotherapy / adverse effects*
Cisplatin / adverse effects
Cisplatin / therapeutic use
Esophagitis / etiology*
Esophagitis / genetics
Fluorouracil / adverse effects
Fluorouracil / therapeutic use
Genetic Variation
Humans
Lymph Node Excision
Lymphatic Irradiation / adverse effects*
Lymphatic Metastasis / radiotherapy*
Male
Middle Aged
Neck
Neoplasms, Multiple Primary / genetics
Neoplasms, Unknown Primary
Radiation Injuries / etiology*
Radiation Injuries / genetics
Radiation Tolerance* / genetics
Radiation Tolerance* / physiology
Radiodermatitis / etiology*
Radiodermatitis / genetics
Signal Transduction / genetics
TOR Serine-Threonine Kinases / physiology
Tuberous Sclerosis / genetics
Tuberous Sclerosis / physiopathology*
Tuberous Sclerosis Complex 2 Protein
Tumor Suppressor Proteins / deficiency
Tumor Suppressor Proteins / genetics

Substances

TSC2 protein, human
Tuberous Sclerosis Complex 2 Protein
Tumor Suppressor Proteins
MTOR protein, human
TOR Serine-Threonine Kinases
Cisplatin
Fluorouracil