Radiation-induced brachial plexus neuropathy: A review

Warade, Anshu; Jha, Ashish; Pattankar, Sanjeev; Desai, Ketan

doi:10.4103/0028-3886.250704

Cited by 26 publications

(24 citation statements)

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“…Radiation-induced brachial plexopathy is caused by radiation damage to the brachial plexus [2,4,35] that provide sensation and muscular innervation for the whole hand. Symptoms include paresthesia, dysesthesia, decreased sensitivity, partial loss of movement, complete paralysis of the arm, muscular atrophy, impaired mobility and partial dislocation of the shoulder joint.…”

Section: Brachial Plexopathymentioning

confidence: 99%

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Late side effects of radiation treatment for head and neck cancer

Brook

2020

Radiat Oncol J

169

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Radiation therapy (RT) is often used to treat head and neck cancer (HNC) [1]. RT can damage blood vessels that nourish muscles, nerves, and bones resulting in a progressive "radiation fibrosis syndrome", which causes a variety of complications [2]. The likelihood and severity of complications depends on a number of factors, including the total dose of radiation delivered, over what time it was delivered and what parts of the head and neck received radiation. The side effects of RT for HNC are divided into early (acute) and long-term (chronic) effects [3]. Early side effects occur during the course of therapy and during the immediate post therapy period (approximately 2-3 weeks after the completion of a course of RT). Late effects can manifest any time thereafter, from weeks to years later [4]. Patients are usually most bothered by the early effects of RT, although these will generally resolve over time. Knowledge of the ra-Patients undergoing radiation therapy for head and neck cancer (HNC) experience significant early and long-term side effects. The likelihood and severity of complications depends on a number of factors, including the total dose of radiation delivered, over what time it was delivered and what parts of the head and neck received radiation. Late side effects include: permanent loss of saliva; osteoradionecrosis; radiation recall myositis, pharyngoesophageal stenosis; dental caries; oral cavity necrosis; fibrosis; impaired wound healing; skin changes and skin cancer; lymphedema; hypothyroidism, hyperparathyroidism, lightheadedness, dizziness and headaches; secondary cancer; and eye, ear, neurological and neck structures damage. Patients who undergo radiotherapy for nasopharyngeal carcinoma tend to suffer from chronic sinusitis. These side effects present difficult challenges to the patients and their caregivers and require lifelong strategies to alleviate their deleterious effect on basic life functions and on the quality of life. This review presents these side effects and their management.

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Section: Brachial Plexopathymentioning

confidence: 99%

“…Most develop symptoms within the 3 years (range, 6 months to 20 years) [35]. Rehabilitation includes physical and occupational therapies [33].…”

Section: Brachial Plexopathymentioning

confidence: 99%

Late side effects of radiation treatment for head and neck cancer

Brook

2020

Radiat Oncol J

169

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“…It is more likely to occur in patients radiated for breast, lung, head, and neck tumors. The causative mechanism can be direct radiation damage to vascular endothelium near the BP or secondary to progressive fibrosis of the skin, subcutaneous tissue and muscles over the neck [16]. The initial symptom can be paresthesia over the ipsilateral upper limb, which is usually ignored.…”

Section: Radiation-induced Brachial Plexopathymentioning

confidence: 99%

Sonographic Pearls for Imaging the Brachial Plexus and Its Pathologies

et al. 2020

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The brachial plexus (BP) is a complicated neural network, which may be affected by trauma, irradiation, neoplasm, infection, and autoimmune inflammatory diseases. Magnetic Resonance Imaging is the preferred diagnostic modality; however, it has the limitations of high cost and lack of portability. High-resolution ultrasound has recently emerged as an unparalleled diagnostic tool for diagnosing postganglionic lesions of the BP. Existing literature describes the technical skills needed for prompt ultrasound imaging and guided injections for the BP. However, it remains particularly challenging for beginners to navigate easily while scanning its different parts. To address this, we share several “clinical pearls” for the sonographic examination of the BP as well as its common pathologies.

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“…In 2019, Warade et al 12 published a series comprising 11 cases of females with RIBPN (neurogenic pain -visual analog scale 9-10) previously treated for breast carcinoma. In this series, all patients were treated surgically, and neurolysis was undertaken.…”

Section: Discussionmentioning

confidence: 99%

Treatment of radiation-induced brachial plexopathy with omentoplasty

Oliveira¹,

Castro²,

Foroni³

et al. 2020

Autops. Case Rep.

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Radiation-induced brachial plexus neuropathy (RIBPN) is a rare and delayed non-traumatic injury to the brachial plexus, which occurs following radiation therapy to the chest wall, neck, and/or axilla in previously treated patients with cancer. The incidence of RIBPN is more common in patients treated for carcinoma of the breast and Hodgkin lymphoma. With the improvement in radiation techniques, the incidence of injury to the brachial plexus following radiotherapy has dramatically reduced. The currently reported incidence is 1.2% in women irradiated for breast cancer. The progression of symptoms is gradual in about two-thirds of cases; the patients may initially present with paresthesia followed by pain, and later progress to motor weakness in the affected limb. We present the case of a 68-year-old female patient with breast cancer submitted to surgery, chemotherapy, and radiotherapy in the year 2000. Eighteen years later, she developed symptoms and signs compatible with RIBPN and was successfully submitted to omentoplasty for pain control. Omentoplasty is an alternative treatment for RIBPN refractory to conservative treatment, which seems to be effective in improving neuropathic pain. However, postoperative worsening of the motor strength is a real possibility, and all candidates for this type of surgery must be informed about the risk of this complication.

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Radiation-induced brachial plexus neuropathy: A review

Cited by 26 publications

References 0 publications

Late side effects of radiation treatment for head and neck cancer

Late side effects of radiation treatment for head and neck cancer

Sonographic Pearls for Imaging the Brachial Plexus and Its Pathologies

Treatment of radiation-induced brachial plexopathy with omentoplasty

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