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John Varga, MD; U. F. Haustein, MD; Richard H. Creech, MD; James P. Dwyer, DO; Sergio A. Jimenez, MD

JAMA. 1991;265(24):3292-3295.

Abstract
Four patients with stable systemic sclerosis and limited skin involvement received radiation for the treatment of solid malignant neoplasms. Following localized irradiation, each patient developed an exaggerated cutaneous and internal fibrotic reaction in the irradiated areas. The surface area of fibrosis extended beyond the radiation portals employed, and the fibrotic process was poorly responsive to antifibrotic therapy. Three of the patients died of complications caused by fibrous encasement of internal organs. The extent and severity of postradiation fibrosis in these patients was distinctly unusual. These observations suggest that patients with systemic sclerosis are particularly susceptible to developing excessive radiation-induced fibrosis.

(JAMA. 1991;265:3292-3295)

Author Affiliations
From the Department of Medicine, Jefferson Medical College, Philadelphia, Pa (Drs Varga and Jimenez); the Klinik für Hautkrankenheuten, Leipzig, Germany (Dr Haustein); the Fox Chase Cancer Center, Philadelphia, Pa (Dr Creech); and Burlington (NJ) Memorial Hospital (Dr Dwyer).

Footnotes
Reprint requests to Thomas Jefferson University, Room M26, Jefferson Alumni Hall, 1020 Locust St, Philadelphia, PA 19107 (Dr Jimenez).

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