Stereotactic Body Radiation Therapy for Apical Lung Tumors: Dosimetric Analysis of the Brachial Plexus and Preliminary Clinical Outcomes

Morse, R.; Doke, Kaleigh; Ganju, R.G.; Sood, S; Mavroidis, Panayiotis; Chen, Allen M.

doi:10.1016/j.prro.2021.12.002

Cited by 10 publications

(3 citation statements)

References 40 publications

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“…In addition, four studies were excluded due to lack of quantitative data (Platteaux et al., 2010; Sood et al., 2018; Thomas et al., 2015; Truong et al., 2012). Finally, 30 studies were included in the systematic review (Figure 1) (Amini et al., 2012; Basso-Ricci et al., 1980; Brunelli and Brunelli, 1985; Cai et al., 2016; Chen et al., 2012; Eblan et al., 2013; Fardin et al., 1990; Fathers et al., 2002; Forquer et al., 2009; Gosk et al., 2007; Hoeller et al., 2004; Johansson et al., 2000; Kıbıcı et al., 2020; Killer and Hess, 1990; Ko et al., 2011; Kori et al., 1981; LeQuang, 1989; Lindberg et al., 2019; Merle et al., 1988; Metcalfe and Etiz, 2016; Mondrup et al., 1990; Morse et al., 2022; Narakas, 1984; Pierce et al., 1992; Powell et al., 1990; Studer et al., 2014; Teixeira et al., 2007; Warade et al., 2019; Wu et al., 2014; Yin et al., 2023). Figure 2 shows the distribution of the included studies based on the publication year.…”

Section: Resultsmentioning

confidence: 99%

The role of surgery in the management of radiation-induced brachial plexopathy: a systematic review

Shekouhi,

Gerhold,

Chim

2023

J Hand Surg Eur Vol

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This systematic literature review of the clinical characteristics of radiation-induced brachial plexopathy and outcomes after intervention includes 30 trials with 611 patients. The mean radiation dose to the brachial plexus was 56 Gy, and the mean duration of radiation was 4 weeks. The mean time from radiation to the onset of symptoms was 35 months. The most commonly reported symptom was sensory loss ( n = 323, 62%), followed by motor deficits ( n = 294, 56%) and neuropathic pain ( n = 284, 54%). In total, 65 (56%) patients had panplexus involvement and 51 (44%) patients had partial plexus involvement. The most common surgical procedure was neurolysis with flap coverage ( n = 108, 6%), followed by neurolysis alone ( n = 71, 30%). Of the 237 patients who underwent surgery, 125 (53%) reported an improvement in pain. Motor and sensory deficits were improved in 46 (19%) and 39 (16%) patients, respectively, suggesting that surgery is beneficial in relieving pain, but not as beneficial in restoring motor and sensory function.

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Section: Resultsmentioning

confidence: 99%

The role of surgery in the management of radiation-induced brachial plexopathy: a systematic review

Shekouhi,

Gerhold,

Chim

2023

J Hand Surg Eur Vol

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“…For instance, planning MR has been performed in our institution as part of the ongoing phase I/II trial of SBRT for breast cancer patients who are inoperable or refuse breast surgery (ClinicalTrials.gov, NCT03585621). In addition, planning MR is helpful in disease visualization and improving brachial plexus contouring, which has the potential to reduce radiation-related plexopathy of high-dose radiotherapy for recurrent breast cancer, metastatic axillary or supraclavicular nodes, or apical lung tumours [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical implementation of magnetic resonance imaging simulation for radiation oncology planning: 5 year experience

Palhares

Lü

et al. 2023

Radiat Oncol

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Purpose Integrating magnetic resonance (MR) into radiotherapy planning has several advantages. This report details the clinical implementation of an MR simulation (MR-planning) program for external beam radiotherapy (EBRT) in one of North America's largest radiotherapy programs. Methods and materials An MR radiotherapy planning program was developed and implemented at Sunnybrook Health Sciences Center in 2016 with two dedicated wide-bore MR platforms (1.5 and 3.0 Tesla). Planning MR was sequentially implemented every 3 months for separate treatment sites, including the central nervous system (CNS), gynecologic (GYN), head and neck (HN), genitourinary (GU), gastrointestinal (GI), breast, and brachial plexus. Essential protocols and processes were detailed in this report, including clinical workflow, optimized MR-image acquisition protocols, MR-adapted patient setup, strategies to overcome risks and challenges, and an MR-planning quality assurance program. This study retrospectively reviewed simulation site data for all MR-planning sessions performed for EBRT over the past 5 years. Results From July 2016 to December 2021, 8798 MR-planning sessions were carried out, which corresponds to 25% of all computer tomography (CT) simulations (CT-planning) performed during the same period at our institution. There was a progressive rise from 80 MR-planning sessions in 2016 to 1126 in 2017, 1492 in 2018, 1824 in 2019, 2040 in 2020, and 2236 in 2021. As a result, the relative number of planning MR/CT increased from 3% of all planning sessions in 2016 to 36% in 2021. The most common site of MR-planning was CNS (49%), HN (13%), GYN (12%), GU (12%), and others (8%). Conclusion Detailed clinical processes and protocols of our MR-planning program were presented, which have been improved over more than 5 years of robust experience. Strategies to overcome risks and challenges in the implementation process are highlighted. Our work provides details that can be used by institutions interested in implementing an MR-planning program.

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“…RIPN is most frequently reported as brachial plexopathy after breast irradiation and less frequently after irradiation to head and neck and apical thoracic tumors. 1,3 Vagal and recurrent laryngeal nerve palsy has been more recently linked to thoracic SABR, especially in the setting of reirradiation, but the true incidence is unknown. 2,4 Our report is the first to establish phrenic nerve palsy as a late toxicity after a single course of SABR to the lung.…”

Section: Discussionmentioning

confidence: 99%

Radiation-Induced Peripheral Neuropathy After Thoracic Stereotactic Ablative Radiotherapy: Case Report

Pham

Newman

Osmundson

2022

JTO Clinical and Research Reports

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Stereotactic Body Radiation Therapy for Apical Lung Tumors: Dosimetric Analysis of the Brachial Plexus and Preliminary Clinical Outcomes

Cited by 10 publications

References 40 publications

The role of surgery in the management of radiation-induced brachial plexopathy: a systematic review

The role of surgery in the management of radiation-induced brachial plexopathy: a systematic review

Clinical implementation of magnetic resonance imaging simulation for radiation oncology planning: 5 year experience

Radiation-Induced Peripheral Neuropathy After Thoracic Stereotactic Ablative Radiotherapy: Case Report

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