Background:
Radiotherapy is a commonly used cancer treatment modality. However,
radiation-induced complications are major drawbacks, especially at high doses. Radiation-induced
brachial plexopathy (RIBP) is mostly observed in breast and lung cancer patients some months to
years after radiotherapy. RIBP symptoms have negative effects on patients’ quality of life. The
aim of this study was to review RIBP according to the preferred reporting items for systematic
reviews and meta-analyses (PRISMA) guidelines.
Methods:
Online databases (PubMed, Scopus, Web of Science and Embase) were searched to
retrieve relevant studies on brachial plexopathy as a complication of radiotherapy.
Results:
Initial search results yielded a total of 657 articles. After careful screening of their titles
and abstracts, according to the inclusion and exclusion criteria, 31 articles were finally included in
this study. Findings from these 31 papers showed that a total of 9192 cancer patients had undergone
radiotherapy for different regions including chest, axillary area, thoracic outlet, neck and
breast. 26.4% of these patients had RIPB (associated with symptoms such as paresthesia, pain,
weakness, and/or motor dysfunction, organ pathology/dysfunction etc.) with different follow up
times, where 8.2% of patients had RIPB after a mean time of 1.2 years, 15.8% after 2.6 years,
51% after 5 years, 14% after 7.8 years, and 11% after 10.5 years.
Conclusion:
From our findings, we can conclude that the issue of radiation-induced brachial
plexus complication in human is of great concern. Common symptoms associated with this complication
include paresthesia, numbness, pain and weakness. We recommend the use of individual
dose planning and computer-assisted image segmentation techniques that support rapid and reliable
contouring of the brachial plexus. Also, the radiation dose to the brachial plexus should be
limited as much as possible to reduce the risk of brachial plexopathy.
Teaching Video NeuroImage: Myokymia on Muscle Ultrasound in Radiation-Induced Brachial Plexopathy
