Masumoto Akane, Yokoyama Kota, Namba Meika, Sasamura Kazuma, Yoshimura Ryo-Ichi
Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, JPN.
Radiology, Tokyo Medical and Dental University, Tokyo, JPN.
Cureus. 2024 Jan 15;16(1):e52283. doi: 10.7759/cureus.52283. eCollection 2024 Jan.
This case report details a rare instance of radiation-induced brachial plexopathy (RIBP) occurring below the typical tolerance dose in a 55-year-old woman following chemoradiotherapy for apical non-small cell lung carcinoma. Despite receiving a radiation dose considered safe (47-48 Gray in 25 fractions), she developed sensory abnormalities and motor weakness in the right upper limb. The diagnostic distinction between RIBP and tumor recurrence was achieved using MRI, which showed characteristic features of radiation-induced damage. The patient's medical history included smoking and rheumatoid arthritis, highlighting the role of patient-specific factors in the development of RIBP. The case underscores the importance of recognizing RIBP as a potential diagnosis in patients with new-onset brachial plexopathy post-radiation therapy, even when radiation exposure is within conventional safety limits. This report contributes to the literature by demonstrating that RIBP can occur at lower-than-expected radiation doses, especially in the presence of contributing factors like neurotoxic chemotherapy and individual patient risks. It emphasizes the need for careful assessment and management in such cases to distinguish between RIBP and cancer recurrence.
本病例报告详细介绍了一名55岁女性在接受肺尖部非小细胞肺癌放化疗后发生的罕见病例，即低于典型耐受剂量的放射性臂丛神经病变（RIBP）。尽管接受了被认为安全的放射剂量（25次分割，共47 - 48格雷），但她仍出现了右上肢感觉异常和运动无力。通过MRI实现了RIBP与肿瘤复发的诊断鉴别，MRI显示出放射性损伤的特征性表现。患者的病史包括吸烟和类风湿关节炎，突出了患者个体因素在RIBP发生中的作用。该病例强调了即使放射暴露在传统安全限度内，对于放疗后新发臂丛神经病变的患者，将RIBP作为潜在诊断的重要性。本报告通过证明RIBP可在低于预期的放射剂量下发生，特别是在存在神经毒性化疗和个体患者风险等促成因素的情况下，为文献做出了贡献。它强调了在此类病例中仔细评估和管理以区分RIBP和癌症复发的必要性。
