Delayed myeloradiculopathy produced by spinal X-irradiation in the rat

Bradley, Walter G.; Fewings, J. D.; Cumming, W. J. K.; Harrison, R. M.

doi:10.1016/0022-510x(77)90006-5

Cited by 27 publications

(11 citation statements)

References 31 publications

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“…Local ischaemia and fibrosis of soft tissues may be associated with microcirculatory deficiency. Administration of a dose exceeding 10 Gy has caused changes in Schwann cells, endoneural fibroblasts, small vessel wall cells and in perineural cells [20]. Clinical symptoms of plexopathy were observed both when doses for the plexus were below 60 Gy and when they were higher [21].…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy-induced lumbosacral plexopathy in a patient with cervical cancer: a and literature review

Klimek

Kosobucki²,

Łuczyńska³

et al. 2012

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Radiotherapy-induced lumbosacral plexopathy in cervical cancer treatment is a very rare, but extremely serious complication. The clinical course is associated with severe bilateral lower leg pain, reduced sensation, different degrees of weakness, paresis or paralysis, and sometimes also urinary or fecal incontinence. Patient quality of life becomes significantly deteriorated. Escalating neurological disorders may make self-sufficient functioning impossible. Neurological symptoms, most often irreversible, may develop at different times after irradiation, even after more than 30 years. We present a case of neurological toxicity in a patient successfully treated for cervical cancer with pelvis and para-aortic lymph node irradiation and weekly cisplatin. Neurological symptoms developed a few weeks after completion of external irradiation, were gradually escalating and resulted in complete immobilization of the woman. We underline the significance of long-term, systematic physiotherapy and pharmacological therapy which has resulted in significant improvement of motion efficiency. The literature review concerns the questions of frequency, clinical course and mechanisms of radiation-induced plexopathy.

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Section: Discussionmentioning

confidence: 99%

Radiotherapy-induced lumbosacral plexopathy in a patient with cervical cancer: a and literature review

Klimek

Kosobucki²,

Łuczyńska³

et al. 2012

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“…Previous investigators (Kogel and Barendsen, 1974;Mastaglia et al, 1976;Bradley et al, 1977;Kogel, 1977Kogel, , 1979White and Hornsey, 1978) have compared the changes induced by irradiating one area of the spinal cord ( e g , cervical or thoracic) in one animal with those the T i irradiated animals than in the L only gr&p.…”

Section: Discussionmentioning

confidence: 99%

A comparison of histopathologic changes following x‐irradiation of mid‐thoracic and lumbosacral levels of neonatal rat spinal cord

Heard¹,

Gilmore²

1985

Anat. Rec.

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Light microscopic changes were studied in the dorsal funiculi of spinal cords from rats irradiated (4000 R) at 3 days of age and killed from 9-60 days postirradiation (P-I). The irradiated site was limited to a 5-mm length of mid-thoracic spinal cord (T only) in one group of rats, to a 5-mm length of lumbosacral spinal cord (L only) in a second group, and to 5-mm lengths of both mid-thoracic and lumbosacral spinal cord (T/L) in the third group. Changes in the lumbosacral regions were essentially the same in both L only and T/L irradiated groups. These changes included a decreased neuroglial population and a concurrent state of hypomyelination from 9-30 days P-I. In contrast, in the mid-thoracic regions of T only and T/L irradiated groups the decrease in the neuroglial population was obvious only through 13 days P-I, and by 30 days this population resembled that of the controls. The irradiated mid-thoracic areas were hypomyelinated, with the fasciculus gracilis showing a greater degree of hypomyelination than the fasciculus cuneatus. By 25 days P-I, myelination appeared to be normal in these areas. Scattered hemorrhages were noted in both lumbosacral and mid-thoracic regions, but necrotic areas occurred only at the lumbosacral level. In general, the mid-thoracic area appeared to be less sensitive to x-radiation at 3 days of age than the lumbosacral area. These data suggest that there may be marked differences in the developmental states of cells at these two levels at 3 days of age.

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“…21 Administration of 3500 Gy has produced injury to anterior and posterior nerve roots in rodents. 22 The clinical radiation plexopathy syndromes have been described more commonly than have true neoplastic plexopathy. 1,[3][4][5]16,[23][24][25][26][27][28][29] The overall frequency of radiation plexopathy in treated patients is 1.8 to 4.9%.…”

Section: Radiation-induced Plexopathymentioning

confidence: 99%

Neurological Manifestations of Neoplastic and Radiation-Induced Plexopathies

Jaeckle¹

2004

Semin Neurol

111

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Metastatic plexopathy is often a disabling accompaniment of advanced systemic cancer and may involve any of the peripheral nerve plexuses. Brachial plexopathy most commonly occurs in carcinoma of the breast and lung; lumbosacral plexopathy is most common with colorectal and gynecologic tumors, sarcomas, and lymphomas. Regardless of the location, neoplastic plexopathy is often characterized by severe, unrelenting pain. Later, weakness and focal sensory disturbances occur in the distribution of plexus involvement. In previously treated patients, the main differential diagnostic consideration is radiation-induced plexopathy. Treatment of metastatic plexopathy is palliative and includes radiotherapy to the tumor mass, chemotherapy, and symptomatic treatment. In selected cases, subtotal surgical resection of the tumor may be warranted. The response to therapy is modest and generally short-lived. Efforts should be made to provide adequate pain control, maximize remaining neurological function, and prevent complications of immobility produced by the neuromuscular dysfunction.

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Delayed myeloradiculopathy produced by spinal X-irradiation in the rat

Cited by 27 publications

References 31 publications

Radiotherapy-induced lumbosacral plexopathy in a patient with cervical cancer: a and literature review

Radiotherapy-induced lumbosacral plexopathy in a patient with cervical cancer: a and literature review

A comparison of histopathologic changes following x‐irradiation of mid‐thoracic and lumbosacral levels of neonatal rat spinal cord

Neurological Manifestations of Neoplastic and Radiation-Induced Plexopathies

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