Pathophysiology of Radiation Fibrosis Syndrome

Kline-Quiroz, Cristina; Byrd, Hayden; Dovgan, Jake; Lockney, Natalie

doi:10.1007/s40141-023-00403-9

Cited by 1 publication

(4 citation statements)

References 75 publications

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“…This is a clinical diagnosis [93,95,96]. Detailed oncologic history is critical, including total radiation dose and dose per fraction [96,102]. Physical exam should begin with inspection, assessing for any postural abnormality, muscle atrophy, or skin abnormality which may be useful to speculate radiation field and identify structures involved in the field [93].…”

Section: Discussionmentioning

confidence: 99%

“…Nervestabilizing medications (gabapentin, pregabalin, duloxetine, and tricyclic antidepressants) are commonly used for neuropathic pain. NSAIDS and opioids can be used for pain [98,102]. CSI and trigger point injections can target specific pain generators.…”

Section: Managementmentioning

confidence: 99%

“…CSI and trigger point injections can target specific pain generators. Botulinum toxin injections can be performed for spasms however caution is needed as injecting to posterior cervicothoracic muscle may exacerbate neck extension weakness [102].…”

Section: Managementmentioning

confidence: 99%

“…PT and OT play crucial roles in addressing RFS-related shoulder dysfunction. These therapies focus on improving posture, strength, ROM, overall conditioning, function, and independence in daily activities [102]. Evidence supports the effectiveness of interventions such as myofascial release, progressive resistance training, and neuromuscular re-education in improving shoulder dysfunction [93].…”

Section: Managementmentioning

confidence: 99%

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Evaluation and Management of Shoulder Dysfunction in Cancer Survivors

Lee,

Stubblefield

2024

Curr Phys Med Rehabil Rep

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Purpose of Review Shoulder dysfunction widely affects function and quality of life of cancer survivors. This paper discusses the etiology, identification, evaluation, and management of the common shoulder impairments seen in cancer survivors, particularly those with breast cancer, head and neck cancer, and Hodgkin lymphoma. Recent Findings Shoulder dysfunction can be caused by a wide range of sources, often as a sequelae of cancer treatments including surgery, systemic therapy, and radiation therapy. These can change the shoulder biomechanics leading to musculoskeletal disorders such as rotator cuff disease and adhesive capsulitis. Other etiologies include neuromuscular complications, such as post-breast surgery pain syndrome and radiation fibrosis syndrome, and lymphovascular disorders such as lymphedema and axillary web syndrome. Metastatic bone disease and primary bone cancer should be considered for those with intense shoulder pain. Detailed history and physical exam, and in some cases, imaging can assist with evaluation of shoulder issues. Exercise, physical and occupation therapy are essential in managing shoulder dysfunction. Summary Shoulder dysfunction can limit function and quality of life for cancer survivors. It is important to consider the possible etiologies as accurate diagnosis is critical for optimal treatment.

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