Radiation-induced brachial plexopathy: Neurological follow-up in 161 recurrence-free breast cancer patients
| Autor: | Niels Kjær Olsen, Henrik Daa Schrøder, Per Pfeiffer, Lis Johannsen, Carsten Rose |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Cyclophosphamide Denmark medicine.medical_treatment Breast Neoplasms Breast cancer Antineoplastic Combined Chemotherapy Protocols medicine Adjuvant therapy Humans Brachial Plexus Radiology Nuclear Medicine and imaging Aged Mastectomy Simple Chemotherapy Radiation Radiotherapy business.industry Incidence Peripheral Nervous System Diseases Middle Aged medicine.disease Combined Modality Therapy Surgery Radiation therapy Oncology Female Brachial Plexopathy business Brachial plexus Mastectomy Follow-Up Studies medicine.drug |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 26:43-49 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/0360-3016(93)90171-q |
| Popis: | Purpose: The purpose was to assess the incidence and clinical manifestations of radiation-induced brachial plexopathy in breast cancer patients, treated according to the Danish Breast Cancer Cooperative Group protocols. Methods and Materials: One hundred and sixty-one recurrence-free breast cancer patients were examined for radiation-induced brachial plexopathy after a median follow-up period of 50 months (13–99 months). After total mastectomy and axillary node sampling, high-risk patients were randomized to adjuvant therapy. One hundred twenty-eight patients were treated with postoperative radiotherapy with 50 Gy in 25 daily fractions over 5 weeks. In addition, 82 of these patients received cytotoxic therapy (cyclophosphamide, methotrexate, and 5-fluorouracil) and 46 received tamoxifen. Results: Five percent and 9% of the patients receiving radiotherapy had disabling and mild radiation-induced brachial plexopathy, respectively. Radiation-induced brachial plexopathy was more frequent in patients receiving cytotoxic therapy (p = 0.04) and in younger patients (p = 0.04). The clinical manifestations were paraesthesia (100%), hypaesthesia (74%), weakness (58%), decreased muscle stretch reflexes (47%), and pain (47%). Conclusion: The brachial plexus is more vulnerable to large fraction size. Fractions of 2 Gy or less are advisable. Cytotoxic therapy adds to the damaging effect of radiotherapy. Peripheral nerves in younger patients seems more vulnerable. Radiation-induced brachial plexopathy occurs mainly as diffuse damage to the brachial plexus |
| Databáze: | OpenAIRE |
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