Hypersensitivity to radiation therapy in a patient with tuberous sclerosis: Biological considerations about a clinical case [Hypersensibilit?? ?? la radioth??rapie chez un patient atteint de la scl??rose tub??reuse de Bourneville : R??flexions biologiques ?? partir d'un cas clinique]

摘要

A 61-year-old man, with a tuberous sclerosis, experienced severe acute reactions during a concomitant chemoradiotherapy regimen after 22. Gy and one cycle of 5-fluorouracil-cisplatinum. He was treated for a cervical squamous cell lymph node of unknown origin. Grade 3 mucitis and epitheliitis were observed only in the irradiated fields and required the end of the radiotherapy. Tuberous sclerosis is characterized by a loss of the TSC2 function, with a permanent activation of the mTOR pathway. Logically, some kind of " radioresistance" should be observed. Increased radiosensitivity is paradoxical. This case illustrates how radiosensitivity is a complex phenomenon and clinically unpredictable. Efficiency of the protocols associations of mTOR inhibitors and radiotherapy should be carefully scrutinized. ? 2012 Soci??t?? fran?aise de radioth??rapie oncologique (SFRO).