An Ambiguous Phenomenon of Radiation and Drugs: Recall Reactions

Abstract

The term ‘radiation recall’ describes an acute inflammatoryreaction in previously irradiated areas after the administrationof certain inciting systemic agents. It wasfirst described in 1959 by D’Angio that dermatitis is relatedto the application of actinomycin D on the skin.Though this reaction occurs frequently on the skin, itmay also be seen in the oral mucosa, the larynx, esophagus,small intestine, lungs, muscle tissue, and brain.Most drugs associated with recall reactions are cytotoxics,however, several other drugs may also elicit the phenomenon.Although this phenomenon is well known, itsetiology is not understood. Radiation recall reactions aregenerally associated with megavoltage radiotherapy. Thetime interval between the completion of radiotherapyand the recall reaction ranges from days to years. Therecall reaction occurs on average 8 days (3 days to 2months) after the application of the promoting agent. Althoughno standard treatment exists, some authors suggestdiscontinuation of the inciting drug and the use ofcorticosteroids or nonsteroidal anti-inflammatory agents.