Polyradiculopathy post-concomitant chemoradiation for carcinoma of the uterine cervix treated with pelvic and para-aortic fields.
BACKGROUND
It is becoming more common to include the para-aortic lymph nodes in the radiation fields of patients treated with concomitant weekly cisplatin for node-positive squamous cell carcinoma of the cervix.


METHODS
We report on two patients who developed unexpected subacute neurological toxicity with lower extremity paresis and paresthesis, beginning 1 and 4 months post-treatment.


CONCLUSIONS
We believe this to be a rare side effect of chemoradiation. As the dose delivered to the spinal nerve roots was less than 37 Gy in 25 fractions, we believe that the extended fields and concomitant cisplatin had a synergistic effect on the nerves.
Coulombe
Genevieve
G
Department of Radiation Oncology, Vancouver Cancer Center, British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, BC, Canada V5Z 4E6. gcoulombe@bccancer.bc.ca
Thiessen
Brian
B
Balkwill
Susan
S
Aquino-Parsons
Christina
C
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D010291:Paresis / Q000139:chemically induced / Q000209:etiology; D010292:Paresthesia / Q000139:chemically induced / Q000209:etiology; D011128:Polyradiculopathy / Q000139:chemically induced / Q000209:etiology*; D011832:Radiation Injuries / Q000139:chemically induced / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*
D000970:Antineoplastic Agents; D002945:Cisplatin