Brachial Plexopathy as a Complication of Radiotherapy: A Systematic Review

2020 ◽  
Vol 16 (2) ◽  
pp. 110-120
Author(s):  
Dheyauldeen Shabeeb ◽  
Ahmed E. Musa ◽  
Mansoor Keshavarz ◽  
Ehsan Mihandoust ◽  
Gholamreza Hassanzadeh ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Cancer Patients ◽  
Motor Dysfunction ◽  
Computer Assisted ◽  
Brachial Plexopathy ◽  
Negative Effects ◽  
Lung Cancer Patients ◽  
Radiation Induced ◽  
High Doses ◽  
Meta Analyses

Background: Radiotherapy is a commonly used cancer treatment modality. However, radiation-induced complications are major drawbacks, especially at high doses. Radiation-induced brachial plexopathy (RIBP) is mostly observed in breast and lung cancer patients some months to years after radiotherapy. RIBP symptoms have negative effects on patients’ quality of life. The aim of this study was to review RIBP according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Methods: Online databases (PubMed, Scopus, Web of Science and Embase) were searched to retrieve relevant studies on brachial plexopathy as a complication of radiotherapy. Results: Initial search results yielded a total of 657 articles. After careful screening of their titles and abstracts, according to the inclusion and exclusion criteria, 31 articles were finally included in this study. Findings from these 31 papers showed that a total of 9192 cancer patients had undergone radiotherapy for different regions including chest, axillary area, thoracic outlet, neck and breast. 26.4% of these patients had RIPB (associated with symptoms such as paresthesia, pain, weakness, and/or motor dysfunction, organ pathology/dysfunction etc.) with different follow up times, where 8.2% of patients had RIPB after a mean time of 1.2 years, 15.8% after 2.6 years, 51% after 5 years, 14% after 7.8 years, and 11% after 10.5 years. Conclusion: From our findings, we can conclude that the issue of radiation-induced brachial plexus complication in human is of great concern. Common symptoms associated with this complication include paresthesia, numbness, pain and weakness. We recommend the use of individual dose planning and computer-assisted image segmentation techniques that support rapid and reliable contouring of the brachial plexus. Also, the radiation dose to the brachial plexus should be limited as much as possible to reduce the risk of brachial plexopathy.

TH-C-224C-05: Analysis of Radiation-Induced Pneumonitis in Lung Cancer Patients

2006 ◽  
Vol 33 (6Part22) ◽  
pp. 2274-2274
Author(s):  
O Gayou ◽  
D Parda ◽  
M Miften
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Lung Cancer Patients ◽  
Radiation Induced

Reversal of anorexia with megestrol acetate (MA): Impact on quality of life (QoL) in non-metastasic lung cancer patients (pts) undergoing radiation therapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18613-18613 ◽  
Author(s):  
J. Pardo ◽  
A. Mena ◽  
A. Monleon ◽  
V. Macias ◽  
J. Sole ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Life Questionnaire ◽  
Negative Effects ◽  
Lung Cancer Patients ◽  
Related Quality ◽  
The Difference

18613 Background: Anorexia is a common and major problem in cancer patients. Its ethiology is multifactorial and has negative effects on pts QoL. Up to 30% of non-metastasic lung cancer pts receiving radiotherapy will develop anorexia during treatment. We conducted a randomized trial comparing the efficacy of two different doses of MA. The results of the first 130 pts included, presented at ASCO 2003, indicated that MA at doses of 600 mg/day is significantly more effective in the treatment of anorexia in these pts than low doses (320 mg/day) of MA. Here we present the results of the quality of life sub-study which purpose is to evaluate the effect of reversing anorexia in pts health related quality of life (HRQOL). Methods: From February 1999 to April 2003, 160 non-mestastatic lung cancer pts who developed anorexia during radiotherapy were randomized to receive either 320 mg/day or 600 mg/day of MA. All pts who developed anorexia filled up the EuroQuol (EQ-5D) quality of life questionnaire before treated with MA and the responders did it again when appetite was regained. The endpoint was improvement in pts HRQOL (defined as an increase > 5 mm in the EQVAS score between the second and first questionnaires). Results: The analysis of the EuroQuol (EQ-5D) questionnaires of the 131 pts who responded to treatment with MA shows that 106 pts (81%) had an improvement > 5 mm in the EQVAS score while 19 % did not. The difference is statistically significant (Binomial test: p < 0.0001). Regarding differences between the two series, 42 pts improved in the 320 mg arm versus 64 in the 600 mg arm which is not statistically significant (Fisher test: p = 0.501). Conclusions: Our results indicate that reversal of anorexia with MA has a clinically significant improvement in HRQOL in non-metastatic lung cancer pts undergoing radiation therapy. The absence of statistically significant differences between the two series may be due to the sample size. [Table: see text] No significant financial relationships to disclose.

Predictive SNPs for radiation-induced damage in lung cancer patients with radiotherapy: a potential strategy to individualize treatment

2015 ◽  
Vol 30 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Qian Huang ◽  
Fangwei Xie ◽  
Xuenong Ouyang
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Radiation Pneumonitis ◽  
Genetic Profile ◽  
Genetic Determinants ◽  
Human Diversity ◽  
Lung Cancer Patients ◽  
Radiation Induced ◽  
Individualize Treatment ◽  
Potential Strategy

In the treatment of lung cancer, radiotherapy has become one of the most important therapies, despite its sometimes unpredictable side effects. As such, identifying lung cancer patients who are at high risk of developing severe radiation-induced damage (mainly radiation pneumonitis and radiation-induced esophageal toxicity) and applying effect intervention or monitoring techniques are important. Although human diversity to a certain amount is explained by clinical and dosimetric factors, the presence of specific genetic determinants also influences the occurrence of radiation-induced damage. Here we summarize the data on mechanisms of radiation pneumonitis and radiation-induced esophageal toxicity supporting the involvement of variances of genes in the evolution of radiation-induced damage. Furthermore, the available evidence from current clinical studies of genetic polymorphisms for the prediction of radiation pneumonitis and radiation-induced esophageal toxicity is discussed. Eventually, this may help to truly individualize radiotherapy, using a personal genetic profile of the most relevant genes for each lung cancer patient.

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