Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Florida, Gainesville, FL, USA.
College of Medicine, Florida State University College of Medicine, Tallahassee, FL, USA.
J Hand Surg Eur Vol. 2024 Apr;49(4):490-498. doi: 10.1177/17531934231197794. Epub 2023 Sep 8.
This systematic literature review of the clinical characteristics of radiation-induced brachial plexopathy and outcomes after intervention includes 30 trials with 611 patients. The mean radiation dose to the brachial plexus was 56 Gy, and the mean duration of radiation was 4 weeks. The mean time from radiation to the onset of symptoms was 35 months. The most commonly reported symptom was sensory loss ( = 323, 62%), followed by motor deficits ( = 294, 56%) and neuropathic pain ( = 284, 54%). In total, 65 (56%) patients had panplexus involvement and 51 (44%) patients had partial plexus involvement. The most common surgical procedure was neurolysis with flap coverage ( = 108, 6%), followed by neurolysis alone ( = 71, 30%). Of the 237 patients who underwent surgery, 125 (53%) reported an improvement in pain. Motor and sensory deficits were improved in 46 (19%) and 39 (16%) patients, respectively, suggesting that surgery is beneficial in relieving pain, but not as beneficial in restoring motor and sensory function.
这篇关于放射性臂丛神经病的临床特征和干预后结果的系统文献回顾包括 30 项试验，共 611 名患者。臂丛神经的平均放射剂量为 56Gy，放射持续时间平均为 4 周。从放射到症状出现的平均时间为 35 个月。最常见的报告症状是感觉丧失（ = 323，62%），其次是运动缺陷（ = 294，56%）和神经病理性疼痛（ = 284，54%）。共有 65 名（56%）患者有全臂丛受累，51 名（44%）患者有部分臂丛受累。最常见的手术是神经松解加皮瓣覆盖（ = 108，6%），其次是单纯神经松解（ = 71，30%）。在接受手术的 237 名患者中，有 125 名（53%）报告疼痛有所改善。运动和感觉缺陷分别有 46 名（19%）和 39 名（16%）患者得到改善，这表明手术对缓解疼痛有益，但对恢复运动和感觉功能的益处不大。
