Department of Neurology, Rehabilitation Medicine Service, Memorial Sloan-Kettering Cancer Center, MSKCC Outpatient Rehabilitation Center, NY 10022, USA.
PM R. 2011 Nov;3(11):1041-54. doi: 10.1016/j.pmrj.2011.08.535.
Radiation-induced toxicity is a major cause of long-term disability after cancer treatment. Radiation fibrosis describes the insidious pathologic fibrotic tissue sclerosis that can occur in response to radiation exposure. Radiation fibrosis syndrome describes the myriad clinical manifestations of progressive fibrotic tissue sclerosis resulting from radiation treatment. Radiation-induced damage can include "myelo-radiculo-plexo-neuro-myopathy," causing muscle weakness and dysfunction and contributing to neuromuscular injury. Similarly, radiation damage to neuromuscular structures contributes to radiation-induced trismus and cervical dystonia in head and neck cancer survivors. This narrative review discusses the pathophysiology, anatomy, evaluation, and treatment of neuromuscular, musculoskeletal, and functional disorders that can result as late effects of radiation treatment. Rehabilitation medicine physicians with extensive training in neuromuscular and musculoskeletal medicine as well as in the principles of functional restoration are uniquely positioned to help lead efforts to improve the quality of life for cancer survivors with radiation fibrosis syndrome.
放射性毒性是癌症治疗后长期残疾的主要原因。放射性纤维化描述了一种潜在的病理性纤维组织硬化，它可能是对辐射暴露的反应。放射性纤维化综合征描述了由于放射治疗而导致的进行性纤维组织硬化的多种临床表现。放射性损伤可包括“骨髓-脊神经根-神经丛-肌病”，导致肌肉无力和功能障碍，并导致神经肌肉损伤。同样，辐射对神经肌肉结构的损伤也会导致头颈部癌症幸存者出现放射性张口困难和颈部肌张力障碍。本叙述性综述讨论了可作为放射治疗后晚期效应的神经肌肉、肌肉骨骼和功能障碍的病理生理学、解剖学、评估和治疗。在神经肌肉和肌肉骨骼医学以及功能恢复原则方面接受过广泛培训的康复医学医师，具有独特的优势，可以帮助努力提高患有放射性纤维化综合征的癌症幸存者的生活质量。
