Radiation Oncology/Contraindications
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Contraindications to Radiation Therapy
[edit] Collagen vascular diseases
It is a commonly held notion that collagen vascular diseases--such as lupus, scleroderma, Sjogren's, etc.--are an absolute contraindication to radiotherapy since the effects on normal tissue would be greater, and even severe.
Several studies, however, claim that it is safe to give high dose radiation in these patients:
- Abstract — "Breast-conserving therapy in the setting of collagen vascular disease."
- Higher incidence of complications for schleroderma but not other collagen vascular diseases.
- Abstract — "Radiotherapy for malignancies associated with lupus: case reports of acute and late reactions."
- No severe acute or late reactions in patients with Lupus after radiotherapy
- Review; 2007 PMID 18035210 -- "Radiotherapy in setting of collagen vascular disease." (Wo J, Int J Radiat Oncol Biol Phys. 2007 Dec 1;69(5):1347-53.)
- Published results remain controversial
- Close involvement of rheumatologists. Consider initiating NSAID prior to treatment
[edit] Inherited Hypersensitivity Syndromes
- Some patients with these syndromes may exhibit abnormally severe normal tissue reactions
- Ataxia-Telangiectasia|Ataxia-Telangiectasia is the most striking example
- RT doses may need to be adjusted accordingly
- Ataxia-Telangiectasia: profound sensitivity
- Ataxia-Telangiectasia-Like Disorder
- Nijmegen Breakage Syndrome
- Fanconi Anemia
- Nevoid Basal Cell Carcinoma Syndrome / Gorlin Syndrome: marked skin sensitivity
- Cockayne Syndrome: slight hypersensitivity
- Down's Syndrome
- Gardner's Syndrome
- Usher's Syndrome
