Radiation-induced brachial plexopathy and hypofractionated regimens in adjuvant irradiation of patients with breast cancer-a review

Pain in cancer survivors

“…111 Radiation-induced neuronal injury is characterised by its clinical heterogeneity and variable onset time; some patients experience symptoms within a year of their radiotherapy, while in others problems may occur a decade later. 112 BPN occurrence is influenced by a range of factors including dosimetry (greater dose = faster onset) 113 and age of the patient (younger patients develop symptoms more quickly). 114 Symptomatology of BPN also exhibits considerable variation with some patients experiencing sensory disturbance as their predominant symptom with minimal pain, while other patients may be afflicted by severe neuropathic pain.…”

Rectal cancer irradiation. Long course, short course or something else?

“…Actually, experience has repeatedly learned that many hypofractionated schedules have resulted in unacceptable late toxicity rates and there is a wide spread, and sound scepticism against any type of hypofractionation. The most recent trends in increased use of hypofractionated radiotherapy in for example breast [12] and prostate cancer [13] have raised genuine concerns of 'do we have to learn the lesson once more'.…”

Radiation induced brachial plexopathies

“…There is overwhelming evidence today that fraction sizes of more than 2 Gy produce a high frequency of brachial plexus neuropathies as shown by Galecki et al in this issue of Acta Oncologica [42]. As the symptoms of plexopathies are progressive and irreversible and successful treatment methods are still lacking, prevention is a necessity.…”