Gemcitabine-Related Radiation Recall in a Patient with Metastatic Non-small Cell Lung Cancer

A sixty-seven year old male was treated with palliative radiation therapy due to his right hip joint pain, and the pain was caused by osteolytic right acetabular metastasis. He underwent 30 Gy irradiation and then his painful symptoms disappeared at the 1 month follow-up after radiation therapy. He next received received systemic chemotherapy with 3 cycles of gemcitabine plus cisplatin and then 6 cycles of docetaxel. He visited the emergency room at the time of 4 months after the completion of radiation therapy with complaints of relapsed right hip joint pain. On MRI, localized muscular swelling with infiltration and without contrast-enhancement was seen within the previous radiation field, and the clinical impression was radiation-recall myositis. We provided symptomatic treatment and his right hip joint pain with disability disappeared 2 weeks after the treatment. No relapse of the right hip joint pain developed during the patient’s survival period. We experienced a case of radiation-recall myositis that was related to gemcitabine use after radiation therapy.