Should special precautions be taken patients with Ehlers-Danlos syndrome receiving radiation therapy?
Would you have reservations in treating patients with breast, GI, or pelvic malignancies with radiation alone or concurrent chemoradiation?
Answer from: Radiation Oncologist at Community Practice
Not all EDS is the same. Most commonly, an EDS patient these days is a clinically diagnosed patient with hypermobile joints, possibly stretchy skin, and possibly chronic pain syndrome. That is a very different picture from vascular EDS with a COL3A1 mutation, which is rare and would have the extreme...
Answer from: Radiation Oncologist at Community Practice
Interesting question, and one that a former resident of mine had proposed a few months back. I too had difficulty finding quality data, but agree with your concern regarding the impact of arterial intimal fibrosis in this setting. I did find this case that suggests your concern may be justified...
Answer from: Radiation Oncologist at Academic Institution
That it's not an autoimmune disorder is neither here nor there; it's a question of the integrity of the vasculature after RT. Which isn't to say I know of any solid evidence, but it's a very good question and something to consider with the patients. I did find this interesting presentation.
Comments
Radiation Oncologist at Annapolis Radiology Associates Thank you for this!
Answer from: Radiation Oncologist at Community Practice
To my knowledge, with all the caveats of the limited data in this setting, the most concerning side effect I've seen in patients with EDS non-vascular subtypes treated with RT is a systemic pain flare (joints, skin, etc). Gabapentin, SNRIs, and antihistamines, as well as non-pharmacological approach...
Answer from: Radiation Oncologist at Academic Institution
Does anyone have experience with SBRT for a patient with vascular Ehlers-Danlos Syndrome (vEDS type IV)? The patient has a history of vascular complications. Urologists prefer nonoperative management for an enlarging 3.7 cm renal mass consistent with RCC. IR is cautious about cryotherapy. Is SBRT re...