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J Thorac Dis. 2016 Dec;8(12):E1589-E1593. doi: 10.21037/jtd.2016.12.102.

Pemetrexed-induced radiation recall dermatitis in a patient with lung adenocarcinoma: case report and literature review.

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Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA.
Radiation Oncology, Delta Medix Cancer Care, Scranton, PA, USA.
Division of Medical Oncology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD, USA.


Radiation recall dermatitis (RRD) is an inflammatory reaction in a previously irradiated field subsequent to the administration of pharmacologic or promoting agents. Herein, we describe a 47-year-old man with NSCLC who was treated with radiotherapy and pemetrexed-based chemotherapy three years prior to developing RRD upon resumption of pemetrexed-based chemotherapy. RRD with pemetrexed is rare and consists of five cases reported thus far. Although RRD is a rare phenomenon, it should be considered in any patient with dermatologic reactions that occur at the site of previous exposure to radiation therapy. When severe, RRD can pose a significant, and possibly life-threatening, impediment to the treatment and care of oncology patients. We discuss the time course, natural history, and management of this condition, as well as a connection to internal organ involvement, such as pneumonitis in thoracic oncology patients.


Radiation recall dermatitis (RRD); chemoradiation; non-small cell lung cancer; pemetrexed; radiation therapy

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