Is it an urban legend that autoimmune connective tissue disease are a relative contraindication to radiation? Not exactly. While there was no difference in acute toxicity, this retrospective look at patients with CTD matched with controls receiving breast radiation demonstrates increased late grade 2/3 toxicities among those with autoimmune disease. In particular, late grade 2-3 toxicity was 42% in those with active disease at time of treatment (n=35) versus 11% in those without CTD (n=91). Active disease was defined as documented symptoms and/or medical therapy while receiving radiation. On the bright side, there were no grade 4 toxicities and no apparent increased risk of toxicity with hypofractionation. TBL: Late grade 2-3 toxicity is increased (and as high as 40%) in patients with active CTD during breast radiation but that shouldn't preclude hypofractionation as an option. | Purswani, Int J Radiat Oncol Biol Phy 2021 


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