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Brachial Plexopathy As a Complication of Radiotherapy: A Systematic Review Publisher



Shabeeb D1, 2, 3 ; Musa AE1, 4 ; Keshavarz M5 ; Mihandoust E6 ; Hassanzadeh G7 ; Hadian MR8 ; Shirazi A1, 3 ; Najafi M9
Authors
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Authors Affiliations
  1. 1. Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Physiology, College of Medicine, University of Misan, Misan, Iraq
  3. 3. Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Medical Radiation Engineering, School of Medicine, Islamic Azad University, Tehran, Iran
  7. 7. Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran

Source: Current Cancer Therapy Reviews Published:2020


Abstract

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 under-gone 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 reli-able 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. © 2020 Bentham Science Publishers.
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