Radiation-induced brachial plexus neuropathy in breast cancer patients.
Identifieur interne : 004D91 ( Ncbi/Checkpoint ); précédent : 004D90; suivant : 004D92Radiation-induced brachial plexus neuropathy in breast cancer patients.
Auteurs : N K Olsen [Danemark] ; P. Pfeiffer ; K. Mondrup ; C. RoseSource :
- Acta oncologica (Stockholm, Sweden) [ 0284-186X ] ; 1990.
Descripteurs français
- KwdFr :
- MESH :
- effets indésirables : Antinéoplasiques, Radiothérapie.
- radiothérapie : Tumeurs du sein.
- étiologie : Lymphoedème, Névrite du plexus brachial.
- Adulte, Adulte d'âge moyen, Association thérapeutique, Femelle, Humains, Lymphadénectomie, Études de suivi.
English descriptors
- KwdEn :
- MESH :
- chemical , adverse effects : Antineoplastic Agents.
- adverse effects : Radiotherapy.
- etiology : Brachial Plexus Neuritis, Lymphedema.
- radiotherapy : Breast Neoplasms.
- Adult, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Lymph Node Excision, Middle Aged.
Abstract
The incidence and latency period of radiation-induced brachial plexopathy (RBP) were assessed in 79 breast cancer patients by a neurological follow-up examination at least 60 months (range 67-130 months) after the primary treatment. All patients were treated primarily with simple mastectomy, axillary nodal sampling and radiotherapy (RT). Postoperatively, pre- and postmenopausal patients were randomly allocated chemotherapy or antiestrogen treatment. All patients were recurrence-free at time of examination. Clinically, 35% (25-47%) of the patients had RBP; 19% (11-29%) had definite RBP, i.e. were physically disabled, and 16% (9-26%) had probable RBP. Fifty percent (31-69%) had affection of the entire plexus, 18% (7-36%) of the upper trunk only, and 4% (1-18%) of the lower trunk. In 28% (14-48%) of cases assessment of a definite level was not possible. RBP was more common after radiotherapy and chemotherapy (42%) than after radiotherapy alone (26%) but the difference was not statistically significant (p = 0.10). The incidence of definite RBP was significantly higher in the younger age group (p = 0.02). This could be due to more extensive axillary surgery but also to the fact that chemotherapy was given to most premenopausal patients. In most patients with RBP the symptoms began during or immediately after radiotherapy, and were thus without significant latency. Chemotherapy might enhance the radiation-induced effect on nerve tissue, thus diminishing the latency period. Lymphedema was present in 22% (14-32%), especially in the older patients, and not associated with the development of RBP. In conclusion, the damaging effect of RT on peripheral nerve tissue was documented. Since no successful treatment is available, restricted use of RT to the brachial plexus is warranted, especially when administered concomitantly with cytotoxic therapy.
PubMed: 2261203
Affiliations:
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pubmed:2261203Le document en format XML
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<author><name sortKey="Rose, C" sort="Rose, C" uniqKey="Rose C" first="C" last="Rose">C. Rose</name>
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<term>Antineoplastic Agents (adverse effects)</term>
<term>Brachial Plexus Neuritis (etiology)</term>
<term>Breast Neoplasms (radiotherapy)</term>
<term>Combined Modality Therapy</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Lymph Node Excision</term>
<term>Lymphedema (etiology)</term>
<term>Middle Aged</term>
<term>Radiotherapy (adverse effects)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Antinéoplasiques (effets indésirables)</term>
<term>Association thérapeutique</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lymphadénectomie</term>
<term>Lymphoedème (étiologie)</term>
<term>Névrite du plexus brachial (étiologie)</term>
<term>Radiothérapie (effets indésirables)</term>
<term>Tumeurs du sein (radiothérapie)</term>
<term>Études de suivi</term>
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<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antineoplastic Agents</term>
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<term>Radiothérapie</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Brachial Plexus Neuritis</term>
<term>Lymphedema</term>
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<keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Breast Neoplasms</term>
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<keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Tumeurs du sein</term>
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<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term>
<term>Névrite du plexus brachial</term>
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<term>Combined Modality Therapy</term>
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<term>Lymph Node Excision</term>
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<term>Humains</term>
<term>Lymphadénectomie</term>
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<front><div type="abstract" xml:lang="en">The incidence and latency period of radiation-induced brachial plexopathy (RBP) were assessed in 79 breast cancer patients by a neurological follow-up examination at least 60 months (range 67-130 months) after the primary treatment. All patients were treated primarily with simple mastectomy, axillary nodal sampling and radiotherapy (RT). Postoperatively, pre- and postmenopausal patients were randomly allocated chemotherapy or antiestrogen treatment. All patients were recurrence-free at time of examination. Clinically, 35% (25-47%) of the patients had RBP; 19% (11-29%) had definite RBP, i.e. were physically disabled, and 16% (9-26%) had probable RBP. Fifty percent (31-69%) had affection of the entire plexus, 18% (7-36%) of the upper trunk only, and 4% (1-18%) of the lower trunk. In 28% (14-48%) of cases assessment of a definite level was not possible. RBP was more common after radiotherapy and chemotherapy (42%) than after radiotherapy alone (26%) but the difference was not statistically significant (p = 0.10). The incidence of definite RBP was significantly higher in the younger age group (p = 0.02). This could be due to more extensive axillary surgery but also to the fact that chemotherapy was given to most premenopausal patients. In most patients with RBP the symptoms began during or immediately after radiotherapy, and were thus without significant latency. Chemotherapy might enhance the radiation-induced effect on nerve tissue, thus diminishing the latency period. Lymphedema was present in 22% (14-32%), especially in the older patients, and not associated with the development of RBP. In conclusion, the damaging effect of RT on peripheral nerve tissue was documented. Since no successful treatment is available, restricted use of RT to the brachial plexus is warranted, especially when administered concomitantly with cytotoxic therapy.</div>
</front>
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<affiliations><list><country><li>Danemark</li>
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<name sortKey="Rose, C" sort="Rose, C" uniqKey="Rose C" first="C" last="Rose">C. Rose</name>
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<country name="Danemark"><noRegion><name sortKey="Olsen, N K" sort="Olsen, N K" uniqKey="Olsen N" first="N K" last="Olsen">N K Olsen</name>
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