Congress Abstracts 2005

96

COMPLETE URINARY OBSTRUCTION (CUO) AND RADIATION RECALL DERMATITIS (RRD) ASSOCIATED WITH TAXOTERE: CASE REPORT AND LITERATURE REVIEW. Lourdes Duque, RN, NP-C, MSN, Erma Morales, MSN, NP-C, Pamela Osenenko, RN, Yvette Alejandro, BSN, RN, Janet Cogswell, RN, CNS, and Shirley Hwang, RN, MS, VA New Jersey Health Care System, East Orange, NJ.

Radiation recall is an inflammatory reaction within a previously irradiated area triggered by chemotherapeutic agents. It is an uncommon event and can occur from weeks to years after radiation therapy. The mechanism is unknown. Early recognition of RRD, mucositis or CUO is vital to prevent serious complications. The association of RRD with taxotere is not well known.

We report a patient who developed taxotere induced RRD, CUO and summarize previously published case reports. An 86-year-old man with prostate cancer received external beam radiation to the prostate and pelvis (6840 cGy) in 1992. In 2003, his disease progressed to hormone refractory status, and he received taxotere 30mg/m² IV weekly. After receiving a total of 570 mg/m², he developed a rectangular area of erythema and edema involving the penis, scrotum, legs, and suprapubic area as well as new onset of CUO. CT scan of the pelvis showed no evidence of thrombus or lymphadenopathy. He was treated with Taxotere discontinuation, insertion of Foley catheter, corticosteroids and diuretics with rapid improvement. The skin reaction was attributed to RRD while the CUO was likely due to mucositis of the urethra.

There have been 8 case reports of taxotere associated RRD. All these cases were patients with breast cancer who presented with acute and severe erythema, pain and induration of previously irradiated skin. In all patients, rapid improvements were seen after administration of corticosteroids. Successful rechallenge with taxotere was reported in two patients.

We report the first case of RRD and CUO in a prostate cancer patient. The duration between the radiation and initiation of taxotere was 11 years. This is the longest duration that has been reported. The dramatic recovery of all his symptoms after administration of corticosteroids support this treatment approach.

Taxotere has been recently approved by the FDA for hormone refractory prostate cancer and will be frequently used in patients who have received prior radiotherapy. It is important to recognize the radiation recall phenomenon and its management.