Table 3.

Collection of previous case reports of gemcitabine-induced radiation recall myositis (continued)

Author	Cancer type	Radiation location	Dose	CTx regimen	Time between RT and gemcitabine start	Time between RT completion and recall symptoms	Clinical symptoms/signs	Undergoing chemo at time of symptom onset?	Imaging findings (and modality)	Treatment	Outcome	Post-treatment CTx?
Miura et al. [25]a	NSCLC	Lung	2 Gy × 30 (60 Gy)	Concurrent cisplatin and (80 mg/m2 day 1) and vinorelbine (20 mg/m2, days 1 and 8) followed by vinorelbine (13 mg/m2 biweekly) and gemcitabine (800 mg/m2 biweekly)	3 months	5.5 months	Upper chest muscle pain	N/A	Enhancement of pectoralis muscles (MRI)	NSAIDs	Improvement of symptoms	Yes (gefitinib)
O'Regan et al. [10]	Hodgkin lymphoma	Chest	1.8 Gy × 22 (39.6 Gy)	4 cycles of gemcitabine, vinorelbine, and liposomal doxorubicin (unknown dosage)	2 months	5 months	Worsening bilateral anterior chest pain, pectoralis muscle necrosis by biopsy	No (last dose 2.5 weeks before presentation)	Diffuse bilateral swelling of the pectoral muscles with mild stranding of the adjacent subcutaneous fat (CT)	Analgesics	Complete resolution	Not reported
Patel et al. [26]	Nasopharyngeal carcinoma	Head and neck	70.2 Gy total (fractions N/A)	Gemcitabine (1,000 mg/m2) and oxaliplatin (100 mg/m2) every 2 weeks	N/A (CTx started after RT)	6 months	Bilateral neck pain and swelling with restriction of neck movement	Yes	Diffuse bilateral soft-tissue edema of the muscles in the cervical neck (MRI)	Dexamethasone	Symptoms worsened with tapering of dexamethasone/low-dose prednisone started without recurrence.	Not reported
Pinson et al. [27]b	NSCLC	Lung	3 Gy × 10 (30 Gy)	Carboplatin (AUC 5 on day 1) and gemcitabine (1,000 mg/m2 on days 1 and 8), 3-week cycle	4 weeks	14 weeks	Skin erythema, upper chest muscle pain	Yes	Swelling of the pectoralis major and pectoralis minor (CT)	Ibuprofen	Complete resolution in 3 weeks	Not reported
Squire et al. [14]	NSCLC	Pelvis (left sacroiliac and left acetabulum)	3 Gy × 10 (30 Gy)	Gemcitabine (1,000 mg/m2)	1 month	3 months	Tenderness and discomfort to left hip and buttock, elevated CK	Yes	Edema in gluteal muscles (MRI)	Oral prednisone	Symptoms worsened with tapering of prednisone and improved with increasing doses	Gemcitabine continued for 5 more months, symptoms controlled with prednisone
Welsh et al. [28]	Bladder cancer	Para-sacral region	2.5 Gy × 18 (45 Gy)	Gemcitabine and cisplatin (unknown dosage)	4 weeks	5 months	Pain in bilateral superolateral gluteal regions	Yes	Band-like pattern of edema on gluteal region (MRI)	NSAIDs, prednisone	Complete resolution after 6 weeks, but with visible residual scar and muscular atrophy	CTx continued
Current	Breast cancer	Left thigh (femur)/T12 vertebra	3 Gy × 10 (30 Gy)/24 Gy × 1 (24 Gy)	Gemcitabine (1,000 mg/m2 for days 1 and 8) and herceptin (342 mg every 3 weeks)	54 days/79 days	3 months/5.7 months	Worsening leg pain and swelling/Chest and back pain	Yes	Enlargement of muscles of the left thigh (US)/ T12 fracture and paraspinal fluid collections (MRI)	Dexamethasone/T12 vertebroplasty	Progressive resolution of symptoms after 4-month course of dexamethasone/Reduction of chest and back pain following vertebroplasty	Yes (herceptin)

^aPaper is written in Japanese.

^bPaper is written in Dutch.