Recall phenomenon as hemorrhagic cystitis associated with paclitaxel
Keywords:
hemorrhagic cystitis; uterine cervical neoplasms; paclitaxel; radiotherapy; drug-related side effects and adverse reactionsAbstract
Introduction: Cancer treatment may include radiotherapy and chemotherapy, two modalities with well-documented, although not always overlapping, tolerability profiles. The administration of certain drugs after radiotherapy may induce the radiation recall phenomenon.
Objective: To present a case of paclitaxel-associated hemorrhagic cystitis compatible with radiation recall phenomenon in a patient with a history of pelvic radiotherapy.
Clinical case: A 63-year-old woman with a history of cervical cancer treated with surgery, pelvic radiotherapy, brachytherapy, and concurrent chemotherapy. Subsequently, a second malignancy was diagnosed in the breast, for which she received systemic treatment. After paclitaxel administration, the patient developed macroscopic hematuria and pelvic pain; cystoscopy showed findings compatible with hemorrhagic cystitis. The clinical condition improved after drug discontinuation and inpatient medical management.
Conclusion: Several antineoplastic drugs, such as doxorubicin, docetaxel, paclitaxel, gemcitabine, and capecitabine, have been associated with the radiation recall phenomenon. Although bladder involvement is uncommon, it should be considered in patients with a history of pelvic radiotherapy who develop hematuria after exposure to systemic drugs. Timely recognition allows discontinuation of the triggering agent, initiation of supportive treatment, and reduction of the risk of complications.
Downloads
References
1. Burris HA, Hurtig J. Radiation recall with anticancer agents [Internet]. Oncologist. 2010 [acceso: 12/07/2025];15(11):1227-1237. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21045191/
2. Caloglu M, Yurut-Caloglu V, Cosar-Alas R, Saynak M, Karagol H, Uzal C. An ambiguous phenomenon of radiation and drugs: recall reactions [Internet]. Onkologie. 2007 [acceso: 25/07/2025];30(4):209-14. Disponible en: https://pubmed.ncbi.nlm.nih.gov/17396045/
3. Camidge R, Price A. Characterizing the phenomenon of radiation recall dermatitis [Internet]. Radiother Oncol. 2001 [acceso: 03/08/2025];59(3):237-45. Disponible en: https://pubmed.ncbi.nlm.nih.gov/11369064/
4. Kodym E, Kalinska R, Ehringfeld C, Sterbik-Lamina A, Kodym R, Hohenberg G. Frequency of radiation recall dermatitis in adult cancer patients [Internet]. Strahlenther Onkol. 2004 [acceso: 11/08/2025];180(1):18-21. Disponible en: https://pubmed.ncbi.nlm.nih.gov/15591727/
5. Azria D, Magné N, Zouhair A, Castadot P, Culine S, Ychou M, et al. Radiation recall: a well recognized but neglected phenomenon [Internet]. Cancer Treat Rev. 2005 [acceso: 19/08/2025];31(7):555-70. Disponible en: https://pubmed.ncbi.nlm.nih.gov/16168567/
6. Samaan TMA, Samec M, Liskova A, Kubatka P, Büsselberg D. Paclitaxel’s mechanistic and clinical effects on breast cancer [Internet]. Biomolecules. 2019 [acceso: 28/08/2025];9(12):789. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31783552/
7. Baek SW, Seo YJ, Kim JS, Lee HJ. Radiation recall dermatitis after treatment with paclitaxel and cisplatin. Ann Dermatol. 2012;24(2):223-4. DOI: 10.5021/ad.2012.24.2.223
8. Kundak I, Oztop I, Soyturk M, Ozcan MA, Yilmaz U, Meydan N, et al. Paclitaxel-carboplatin induced radiation recall colitis. Tumori. 2004;90(2):256-8. DOI: 10.1177/030089160409000219
9. Schweitzer VG, Juillard GJ, Bajada CL, Parker RG. Radiation recall dermatitis and pneumonitis in a patient treated with paclitaxel. Cancer. 1995;76(6):1069-72. DOI: 10.1002/1097-0142(19950915)76:6<1069::AID-CNCR2820760623>3.0.CO;2-7
10. Ichioka E, Iguchi-Manaka A, Oikawa T, Sawa A, Okazaki M, Saito T, et al. A case of hemorrhagic cystitis caused by nab-paclitaxel. Int Cancer Conf J. 2016;5(4):187-91. DOI: 10.1007/s13691-016-0255-9
11. Zhang XJ, Lou J. Hemorrhagic cystitis in gastric cancer after nanoparticle albumin-bound paclitaxel: a case report. World J Gastrointest Oncol. 2024;16(3):1084-90. DOI: 10.4251/wjgo.v16.i3.1084
12. Ntekim AI, Ajekigbe A. Hemorrhagic cystitis in a patient receiving docetaxel for prostate cancer. Clin Med Insights Oncol. 2010;4:11-13. DOI: 10.4137/CMO.S4477
13. Grellety T, Houédé N, Hoepffner JL, Rivière J, Mérino C, Lieutenant V, et al. Hemorrhagic cystitis in patients treated with cabazitaxel: a radiation recall syndrome? Ann Oncol. 2014;25(6):1248-9. DOI: 10.1093/annonc/mdu132
14. Manikandan R, Kumar S, Dorairajan LN. Hemorrhagic cystitis: a challenge to the urologist. Indian J Urol. 2010;26(2):159-66. DOI: 10.4103/0970-1591.65380
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Joseph Alburqueque-Melgarejo, José Manuel Vela-Ruiz, Luis Enrique Nieves Cordova, Esther Graciela de los Milagros Cotrina Montenegro, Brady Beltrán Gárate
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who have publications with this Journal accept the following terms:
- The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
- The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
- Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.
