Miha Orazem1,2, Cédric Draulans3,4, Jeroen Dekervel1,5, Karin Haustermans6,7, Mathieu Spaas8, Eric Van Cutsem1,5, Marina Debecker9,10, Gert De Meerleer1,2, Sabine Tejpar1,5. 1. Department of Oncology, KU Leuven, Leuven, Belgium. 2. Department of Radiation Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia. 3. Department of Oncology, KU Leuven, Leuven, Belgium. cedric.draulans@uzleuven.be. 4. Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium. cedric.draulans@uzleuven.be. 5. Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium. 6. Department of Oncology, KU Leuven, Leuven, Belgium. karin.haustermans@uzleuven.be. 7. Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium. karin.haustermans@uzleuven.be. 8. Department of Radiation Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium. 9. Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium. 10. Department of Radiation Oncology, Europe Hospitals Brussels, Brussels, Belgium.
Abstract
PURPOSE: Multimodality treatments combining radiotherapy, immune therapy and/or targeted therapy are under heavy investigation. Promising data from clinical trials are emerging, nevertheless unexpected interactions and adverse events should not be overlooked. CASE PRESENTATION: Here we present a case study of a patient with metastatic colon adenocarcinoma treated sequentially with a chemotherapy/targeted therapy combination, immune checkpoint inhibitors and ultra-hypofractionated radiotherapy. After radiation treatment, the patient developed extensive posterior abdominal wall wounds coinciding with regression of the irradiated metastatic tumour mass and marked elevation of the inflammation parameters. CONCLUSION: This case represents an unusual fatal wound complication after palliative ultra-hypofractionated radiotherapy. Further research into synergistic effects of sequential radiotherapy and anti-angiogenesis therapy may provide an advantage in anticipating severe sequelae.
PURPOSE: Multimodality treatments combining radiotherapy, immune therapy and/or targeted therapy are under heavy investigation. Promising data from clinical trials are emerging, nevertheless unexpected interactions and adverse events should not be overlooked. CASE PRESENTATION: Here we present a case study of a patient with metastatic colon adenocarcinoma treated sequentially with a chemotherapy/targeted therapy combination, immune checkpoint inhibitors and ultra-hypofractionated radiotherapy. After radiation treatment, the patient developed extensive posterior abdominal wall wounds coinciding with regression of the irradiated metastatic tumour mass and marked elevation of the inflammation parameters. CONCLUSION: This case represents an unusual fatal wound complication after palliative ultra-hypofractionated radiotherapy. Further research into synergistic effects of sequential radiotherapy and anti-angiogenesis therapy may provide an advantage in anticipating severe sequelae.
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