Role of radiation therapy in patients with a diagnosis of both systemic lupus erythematosus and cancer

Benk, V.; Al‐Herz, Adeeba; Gladman, Dafna D.; Urowitz, Murray B.; Fortin, Paul R.

doi:10.1002/art.20912

Cited by 35 publications

(23 citation statements)

References 28 publications

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“…Also, some therapeutic measures may be inappropriately withheld from patients with SLE who develop cancer. 15 Other possible reasons for our observed data include decreased survival related to SLE comorbidity.…”

Section: Discussionmentioning

confidence: 88%

Non-Hodgkin's lymphoma in systemic lupus erythematosus

Bernatsky

Ramsey‐Goldman

Rajan

et al. 2005

Annals of the Rheumatic Diseases

123

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Background: Recent evidence supports an association between systemic lupus erythematosus (SLE) and nonHodgkin's lymphoma (NHL). Objectives: To describe demographic factors, subtypes, and survival of patients with SLE who develop NHL. Methods: A multi-site cohort of 9547 subjects with definite SLE was assembled. Subjects at each centre were linked to regional tumour registries to determine cancer cases occurring after SLE diagnosis. For the NHL cases ascertained, descriptive statistics were calculated, and NHL subtype frequency and median survival time of patients determined.Results: 42 cases of NHL occurred in the patients with SLE during the 76 948 patient-years of observation. The median age of patients at NHL diagnosis was 57 years. Thirty six (86%) of the 42 patients developing NHL were women, reflecting the female predominance of the cohort. In the patients, aggressive histological subtypes appeared to predominate, with the most commonly identified NHL subtype being diffuse large B cell (11 out of 21 cases for which histological subtype was available). Twenty two of the patients had died a median of 1.2 years after lymphoma diagnosis. Conclusions: These data suggest aggressive disease in patients with SLE who develop NHL. Continuing work should provide further insight into the patterns of presentation, prognosis, and aetiology of NHL in SLE.

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Section: Discussionmentioning

confidence: 88%

Non-Hodgkin's lymphoma in systemic lupus erythematosus

Bernatsky

Ramsey‐Goldman

Rajan

et al. 2005

Annals of the Rheumatic Diseases

123

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“…The cause is not known. These disorders may include scleroderma, systemic lupus erythematosus, and possibly rheumatoid arthritis, although there is controversy regarding whether systemic lupus erythematosus predisposes patients to these effects ( 9,(42)(43)(44)(45)(46). It has been suggested that concomitant administration of some medications may be a factor in sensitizing these patients ( 47 ).…”

Section: Initiating Dose and Time Course Of Radiation Injurymentioning

confidence: 99%

Fluoroscopically Guided Interventional Procedures: A Review of Radiation Effects on Patients’ Skin and Hair

Balter¹,

Hopewell²,

Miller³

et al. 2010

Radiology

508

398

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Most advice currently available with regard to fluoroscopic skin reactions is based on a table published in 1994. Many caveats in that report were not included in later reproductions, and subsequent research has yielded additional insights. This review is a consensus report of current scientific data. Expected skin reactions for an average patient are presented in tabular form as a function of peak skin dose and time after irradiation. The text and table indicate the variability of reactions in different patients. Images of injuries to skin and underlying tissues in patients and animals are provided and are categorized according to the National Cancer Institute skin toxicity scale, offering a basis for describing cutaneous radiation reactions in interventional fluoroscopy and quantifying their clinical severity. For a single procedure performed in most individuals, noticeable skin changes are observed approximately 1 month after a peak skin dose exceeding several grays. The degree of injury to skin and subcutaneous tissue increases with dose. Specialized wound care may be needed when irradiation exceeds 10 Gy. Residual effects from radiation therapy and from previous procedures influence the response of skin and subcutaneous tissues to subsequent procedures. Skin irradiated to a dose higher than 3-5 Gy often looks normal but reacts abnormally when irradiation is repeated. If the same area of skin is likely to be exposed to levels higher than a few grays, the effects of previous irradiation should be included when estimating the expected tissue reaction from the additional procedure.

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“…Benk et al. attempted to determine whether radiation therapy is denied to patients with lupus and whether it can cause excessive toxicity (31). Forty cases of cancer in 38 SLE patients were identified.…”

Section: Sle and Rt For Breast Cancermentioning

confidence: 99%

“…Ten breast cancer patients received curative radiation treatment and none suffered severe complications (grade III or more). Benk et al attempted to determine whether radiation therapy is denied to patients with lupus and whether it can cause excessive toxicity (31). Forty cases of cancer in 38 SLE patients were identified.…”

Section: Sle and Rt For Breast Cancermentioning

confidence: 99%

Systemic Lupus Erythematosus and Breast Cancer

Kontos

Fentiman

2008

The Breast Journal

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There is evidence that certain connective tissue diseases such as scleroderma are associated with an increased risk of malignancy. Although it has been claimed that systemic lupus erythematosus (SLE) carries an increased risk of breast cancer, review of the available literature suggests that this is not the case, or, any increase is very small. Women with SLE do not need to be under close surveillance for breast cancer. In patients suffering from both SLE and breast cancer, radiotherapy has been regarded as relatively contraindicated because of fears concerning early and late complications. This view is not supported by the available literature and the majority of such cases can be treated by standard breast-conserving therapy, including breast irradiation.

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Role of radiation therapy in patients with a diagnosis of both systemic lupus erythematosus and cancer

Cited by 35 publications

References 28 publications

Non-Hodgkin's lymphoma in systemic lupus erythematosus

Non-Hodgkin's lymphoma in systemic lupus erythematosus

Fluoroscopically Guided Interventional Procedures: A Review of Radiation Effects on Patients’ Skin and Hair

Systemic Lupus Erythematosus and Breast Cancer

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