Metcalfe Evrim, Etiz Durmus
Department of Radiation Oncology, Eskisehir Osmangazi University School of Medicine, Turkey.
Contemp Oncol (Pozn). 2016;20(1):67-72. doi: 10.5114/wo.2015.55876. Epub 2016 Mar 16.
Early transient brachial plexopathy following radiotherapy (RT) in patients with head and neck cancer may be underreported and associated with a dose-response. Our purpose was to determine the incidence of early transient radiation-ınduced brachial plexopathy (RIBP) in patients receiving primary RT (± chemotherapy) for locally advanced head and neck cancer (HNC).
Twenty-seven locally advanced HNC patients who have no finding of brachial plexopathy at the diagnosis were evaluated 3 times by a specifically developed 13-item questionnaire for determining early transient RIBP. The 54 brachial plexus in 27 patients were delineated and dose volume histograms were calculated.
Median follow-up period was 28 (range: 15-40) months. The mean BP volume was 7.9 ±3.6 cm(3), and the mean and maximum doses to the BP were 45.3 (range: 32.3-59.3) Gy, and 59.4 (range: 41.4-70.3) Gy, respectively. Maximum dose to the BP was ≥ 70 Gy only in 2 nasopharyngeal cancer patients. Two (7%) early transient RIBP were reported at 7(th) and 8(th) month after RT under maximum 67.17 and 55.37 Gy, and mean 52.95 and 38.60 Gy RT doses.
Two (7%) early RIBP were seen in the patient group, although brachial plexus maximum doses were ≥ 66 Gy in 75% of patients.
头颈部癌患者放疗后早期短暂性臂丛神经病变可能未得到充分报告，且与剂量反应相关。我们的目的是确定局部晚期头颈部癌（HNC）接受原发放疗（±化疗）患者中早期短暂性放射性臂丛神经病变（RIBP）的发生率。
27例诊断时未发现臂丛神经病变的局部晚期HNC患者，通过专门设计的13项问卷进行3次评估，以确定早期短暂性RIBP。勾勒出27例患者的54条臂丛神经，并计算剂量体积直方图。
中位随访期为28（范围：15 - 40）个月。臂丛神经平均体积为7.9±3.6 cm³，臂丛神经的平均剂量和最大剂量分别为45.3（范围：32.3 - 59.3）Gy和59.4（范围：41.4 - 70.3）Gy。仅2例鼻咽癌患者臂丛神经最大剂量≥70 Gy。放疗后第7个月和第8个月报告了2例（7%）早期短暂性RIBP，最大放疗剂量分别为67.17 Gy和55.37 Gy，平均放疗剂量分别为52.95 Gy和38.60 Gy。
尽管75%的患者臂丛神经最大剂量≥66 Gy，但在患者组中仍观察到2例（7%）早期RIBP。
