[Normal tissue tolerance to external beam radiation therapy: peripheral nerves].
Plexopathies and peripheral neuropathies appear progressively and with several years delay after radiotherapy. These lesions are observed principally after three clinical situations: supraclavicular and axillar irradiations for breast cancer, pelvic irradiations for various pathologies and limb irradiations for soft tissue sarcomas. Peripheral nerves and plexus (brachial and lumbosacral) are described as serial structures and are supposed to receive less than a given maximum dose linked to the occurrence of late injury. Literature data, mostly ancient, define the maximum tolerable dose to a threshold of 60 Gy and highlight also a great influence of fractionation and high fraction doses. For peripheral nerves, most frequent late effects are pain with significant differences of occurrence between 50 and 60 Gy. At last, associated pathologies (diabetes, vascular pathology, neuropathy...) and associated treatments have probably to be taken into account as additional factors, which may increase the risk of these late radiation complications.
Henriques de Figueiredo
B
B
Département de Radiothérapie, Institut Bergonié, Centre Régional de Lutte Contre le Cancer, 229 Cours de l'Argonne, 33076 Bordeaux cedex, France. bhenriques@bergonie.org
Huchet
A
A
Dejean
C
C
Mamou
N
N
Sargos
P
P
Loiseau
H
H
Kantor
G
G
D001917:Brachial Plexus / Q000033:anatomy & histology* / Q000528:radiation effects; D019583:Dose Fractionation, Radiation; D006801:Humans; D008160:Lumbosacral Plexus / Q000528:radiation effects; D020714:Maximum Tolerated Dose; D010525:Peripheral Nerves / Q000528:radiation effects*; D011832:Radiation Injuries / Q000209:etiology; D011836:Radiation Tolerance; D011878:Radiotherapy / Q000009:adverse effects* / Q000379:methods; D012307:Risk Factors; D012509:Sarcoma / Q000532:radiotherapy*; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy*