Pradat P F, Poisson M, Delattre J Y
Service de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Rev Neurol (Paris). 1994 Oct;150(10):664-77.
In contrast with the central nervous system, the peripheral nerves are usually considered radioresistant. However, experimental and clinical data show evidence of peripheral nerve injury after radiation therapy. The physiopathology remains unclear. Vascular alterations appear to play an important role. Direct damage to axon or Schwann cell and nervous compression in areas of radiation fibrosis could also be involved. Clinically, brachial plexopathy is a well-recognized complication but all the structures of the peripheral nervous system can be involved: cranial nerves, roots, plexus and nerve trunks. A syndrome of early and reversible plexopathy differs from the classical progressive form with pejorative outcome. Radiation-induced peripheral nerve tumors are infrequent.
与中枢神经系统不同,周围神经通常被认为具有放射抗性。然而,实验和临床数据显示了放射治疗后周围神经损伤的证据。其病理生理学仍不清楚。血管改变似乎起着重要作用。轴突或施万细胞的直接损伤以及放射纤维化区域的神经受压也可能参与其中。临床上,臂丛神经病变是一种公认的并发症,但周围神经系统的所有结构都可能受累:颅神经、神经根、神经丛和神经干。一种早期且可逆的神经丛病变综合征与预后不良的经典进行性形式不同。放射诱导的周围神经肿瘤并不常见。