Radiation-induced bullous pemphigoid: A systematic review of an unusual radiation side effect

Veronique E. M. Mul; Adrienne J. van Geest; Madelon C. G. Pijls-Johannesma; Jan Theys; Tom A. M. Verschueren; Jos J. Jager; Philippe Lambin; Brigitta G. Baumert

doi:10.1016/j.radonc.2006.11.014

Radiation-induced bullous pemphigoid: A systematic review of an unusual radiation side effect

Veronique E. M. Mul, Adrienne J. van Geest, Madelon C. G. Pijls-Johannesma, Jan Theys, Tom A. M. Verschueren, Jos J. Jager, Philippe Lambin, Brigitta G. Baumert^*

^*Corresponding author for this work

GROW - Innovative Cancer Diagnostics & Therapy

Research output: Contribution to journal › (Systematic) Review article › peer-review

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Abstract

Background: Percutaneous radiotherapy (IRT) may cause a range of acute and late side effects of the skin within the irradiated area. In rare cases radiotherapy can cause bullous pemphigoid (BP). BP is reported to occur mainly within irradiated fields following radiation treatment. Exceptionally, BP may arise during RT. It is unclear which mechanism exactly triggers BP following megavoltage irradiation and whether there is a potential association with hormonal anticancer treatment.

Methods: A systematic literature based review was performed. Publications reporting histologically confirmed BP and a treatment with RT were retrieved based on a standardized query using electronic databases. A standardized quality assessment was applied.

Results: Out of 306 potentially relevant publications 21 were identified to be relevant and included in this review. An association between RT and BP was reported in 27 patients. The majority developed BP after RT and a median dose of 50 Gy. Four patients developed BP during RT after a minimal dose of 20 Gy.

Conclusions: BP induced by RT was observed predominantly in patients with breast cancer. In all reported cases, there is a clear relationship with RT. Therefore, BP may be considered as RT-induced side effect. RT can induce a BP following a minimal dose of 20 Gy. New biological agents may play a role in the future treatment of BP. (c) 2006 Elsevier Ireland Ltd. All rights reserved.

Original language	English
Pages (from-to)	5-9
Number of pages	5
Journal	Radiotherapy and Oncology
Volume	82
Issue number	1
DOIs	https://doi.org/10.1016/j.radonc.2006.11.014
Publication status	Published - Jan 2007

Keywords

bullous pemphigoid
parapemphigus
breast cancer
radiotherapy
X-RAY
RADIOTHERAPY
THERAPY
NIACINAMIDE
TETRACYCLINE
IRRADIATION
EXPRESSION
DERMATITIS
CARCINOMA
DISEASES

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10.1016/j.radonc.2006.11.014

Full TextFinal published version, 1.07 MBLicence: Taverne

Cite this

@article{e7fcead6121d42d48b17a14bcee11c27,

title = "Radiation-induced bullous pemphigoid: A systematic review of an unusual radiation side effect",

abstract = "Background: Percutaneous radiotherapy (IRT) may cause a range of acute and late side effects of the skin within the irradiated area. In rare cases radiotherapy can cause bullous pemphigoid (BP). BP is reported to occur mainly within irradiated fields following radiation treatment. Exceptionally, BP may arise during RT. It is unclear which mechanism exactly triggers BP following megavoltage irradiation and whether there is a potential association with hormonal anticancer treatment.Methods: A systematic literature based review was performed. Publications reporting histologically confirmed BP and a treatment with RT were retrieved based on a standardized query using electronic databases. A standardized quality assessment was applied.Results: Out of 306 potentially relevant publications 21 were identified to be relevant and included in this review. An association between RT and BP was reported in 27 patients. The majority developed BP after RT and a median dose of 50 Gy. Four patients developed BP during RT after a minimal dose of 20 Gy.Conclusions: BP induced by RT was observed predominantly in patients with breast cancer. In all reported cases, there is a clear relationship with RT. Therefore, BP may be considered as RT-induced side effect. RT can induce a BP following a minimal dose of 20 Gy. New biological agents may play a role in the future treatment of BP. (c) 2006 Elsevier Ireland Ltd. All rights reserved.",

keywords = "bullous pemphigoid, parapemphigus, breast cancer, radiotherapy, X-RAY, RADIOTHERAPY, THERAPY, NIACINAMIDE, TETRACYCLINE, IRRADIATION, EXPRESSION, DERMATITIS, CARCINOMA, DISEASES",

author = "Mul, {Veronique E. M.} and {van Geest}, {Adrienne J.} and Pijls-Johannesma, {Madelon C. G.} and Jan Theys and Verschueren, {Tom A. M.} and Jager, {Jos J.} and Philippe Lambin and Baumert, {Brigitta G.}",

year = "2007",

month = jan,

doi = "10.1016/j.radonc.2006.11.014",

language = "English",

volume = "82",

pages = "5--9",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

number = "1",

}

TY - JOUR

T1 - Radiation-induced bullous pemphigoid

T2 - A systematic review of an unusual radiation side effect

AU - Mul, Veronique E. M.

AU - van Geest, Adrienne J.

AU - Pijls-Johannesma, Madelon C. G.

AU - Theys, Jan

AU - Verschueren, Tom A. M.

AU - Jager, Jos J.

AU - Lambin, Philippe

AU - Baumert, Brigitta G.

PY - 2007/1

Y1 - 2007/1

N2 - Background: Percutaneous radiotherapy (IRT) may cause a range of acute and late side effects of the skin within the irradiated area. In rare cases radiotherapy can cause bullous pemphigoid (BP). BP is reported to occur mainly within irradiated fields following radiation treatment. Exceptionally, BP may arise during RT. It is unclear which mechanism exactly triggers BP following megavoltage irradiation and whether there is a potential association with hormonal anticancer treatment.Methods: A systematic literature based review was performed. Publications reporting histologically confirmed BP and a treatment with RT were retrieved based on a standardized query using electronic databases. A standardized quality assessment was applied.Results: Out of 306 potentially relevant publications 21 were identified to be relevant and included in this review. An association between RT and BP was reported in 27 patients. The majority developed BP after RT and a median dose of 50 Gy. Four patients developed BP during RT after a minimal dose of 20 Gy.Conclusions: BP induced by RT was observed predominantly in patients with breast cancer. In all reported cases, there is a clear relationship with RT. Therefore, BP may be considered as RT-induced side effect. RT can induce a BP following a minimal dose of 20 Gy. New biological agents may play a role in the future treatment of BP. (c) 2006 Elsevier Ireland Ltd. All rights reserved.

AB - Background: Percutaneous radiotherapy (IRT) may cause a range of acute and late side effects of the skin within the irradiated area. In rare cases radiotherapy can cause bullous pemphigoid (BP). BP is reported to occur mainly within irradiated fields following radiation treatment. Exceptionally, BP may arise during RT. It is unclear which mechanism exactly triggers BP following megavoltage irradiation and whether there is a potential association with hormonal anticancer treatment.Methods: A systematic literature based review was performed. Publications reporting histologically confirmed BP and a treatment with RT were retrieved based on a standardized query using electronic databases. A standardized quality assessment was applied.Results: Out of 306 potentially relevant publications 21 were identified to be relevant and included in this review. An association between RT and BP was reported in 27 patients. The majority developed BP after RT and a median dose of 50 Gy. Four patients developed BP during RT after a minimal dose of 20 Gy.Conclusions: BP induced by RT was observed predominantly in patients with breast cancer. In all reported cases, there is a clear relationship with RT. Therefore, BP may be considered as RT-induced side effect. RT can induce a BP following a minimal dose of 20 Gy. New biological agents may play a role in the future treatment of BP. (c) 2006 Elsevier Ireland Ltd. All rights reserved.

KW - bullous pemphigoid

KW - parapemphigus

KW - breast cancer

KW - radiotherapy

KW - X-RAY

KW - RADIOTHERAPY

KW - THERAPY

KW - NIACINAMIDE

KW - TETRACYCLINE

KW - IRRADIATION

KW - EXPRESSION

KW - DERMATITIS

KW - CARCINOMA

KW - DISEASES

U2 - 10.1016/j.radonc.2006.11.014

DO - 10.1016/j.radonc.2006.11.014

M3 - (Systematic) Review article

SN - 0167-8140

VL - 82

SP - 5

EP - 9

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

IS - 1

ER -