Recall radiation dermatitis by sorafenib following stereotactic body radiation therapy

Chen-Hsi Hsieh,^1,3,4 Shih-Chiang Lin,² Pei-Wei Shueng,^1,5,6 Deng-Yu Kuo<sup>1

1</sup>Division of Radiation Oncology, Department of Radiology, ²Division of Medical Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; ³Department of Medicine, ⁴Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, ⁵Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan; ⁶Oriental Institute of Technology, New Taipei City, Taiwan

Abstract: We report on a 63-year-old man with a history of hepatitis B virus–related hepatocellular carcinoma with a thrombus extending into the inferior vena cava, who received image-guided stereotactic body radiation therapy (SBRT) with helical tomotherapy, followed by sorafenib. A total tumor dose of 48 Gy was delivered by 6 fractions within 2 weeks. The tumor responded dramatically, and the patient tolerated the courses well. Ten days after SBRT, sorafenib (200 mg), at 1.5 tablets twice a day, was prescribed. One week later, grade 2 recall radiation dermatitis subsequently developed in the previous SBRT off-target area. SBRT followed by sorafenib for the treatment of a portal vein thrombosis provided effective results, but the potential risk of enhanced adverse effects between radiation and sorafenib should be considered with caution, especially under a SBRT scheme.

Keywords: hepatocellular carcinoma, recall radiation dermatitis