Dan Lundstedt1, Magnus Gustafsson2, Gunnar Steineck3, Agnetha Sundberg4, Ulrica Wilderäng5, Erik Holmberg6, Karl-Axel Johansson4, Per Karlsson7. 1. Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden; Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden. Electronic address: dan.lundstedt@gu.se. 2. Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden; Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden; Department of Therapeutic Radiation Physics, Sahlgrenska University Hospital, Gothenburg, Sweden. 3. Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden; Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden; Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden. 4. Department of Therapeutic Radiation Physics, Sahlgrenska University Hospital, Gothenburg, Sweden. 5. Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden; Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden. 6. Regional Cancer Center, Sahlgrenska University Hospital, Gothenburg, Sweden. 7. Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden.
Abstract
PURPOSE: To identify volume and dose predictors of paresthesia after irradiation of the brachial plexus among women treated for breast cancer. METHODS AND MATERIALS: The women had breast surgery with axillary dissection, followed by radiation therapy with (n=192) or without irradiation (n=509) of the supraclavicular lymph nodes (SCLNs). The breast area was treated to 50 Gy in 2.0-Gy fractions, and 192 of the women also had 46 to 50 Gy to the SCLNs. We delineated the brachial plexus on 3-dimensional dose-planning computerized tomography. Three to eight years after radiation therapy the women answered a questionnaire. Irradiated volumes and doses were calculated and related to the occurrence of paresthesia in the hand. RESULTS: After treatment with axillary dissection with radiation therapy to the SCLNs 20% of the women reported paresthesia, compared with 13% after axillary dissection without radiation therapy, resulting in a relative risk (RR) of 1.47 (95% confidence interval [CI] 1.02-2.11). Paresthesia was reported by 25% after radiation therapy to the SCLNs with a V40 Gy ≥ 13.5 cm(3), compared with 13% without radiation therapy, RR 1.83 (95% CI 1.13-2.95). Women having a maximum dose to the brachial plexus of ≥55.0 Gy had a 25% occurrence of paresthesia, with RR 1.86 (95% CI 0.68-5.07, not significant). CONCLUSION: Our results indicate that there is a correlation between larger irradiated volumes of the brachial plexus and an increased risk of reported paresthesia among women treated for breast cancer.
PURPOSE: To identify volume and dose predictors of paresthesia after irradiation of the brachial plexus among women treated for breast cancer. METHODS AND MATERIALS: The women had breast surgery with axillary dissection, followed by radiation therapy with (n=192) or without irradiation (n=509) of the supraclavicular lymph nodes (SCLNs). The breast area was treated to 50 Gy in 2.0-Gy fractions, and 192 of the women also had 46 to 50 Gy to the SCLNs. We delineated the brachial plexus on 3-dimensional dose-planning computerized tomography. Three to eight years after radiation therapy the women answered a questionnaire. Irradiated volumes and doses were calculated and related to the occurrence of paresthesia in the hand. RESULTS: After treatment with axillary dissection with radiation therapy to the SCLNs 20% of the women reported paresthesia, compared with 13% after axillary dissection without radiation therapy, resulting in a relative risk (RR) of 1.47 (95% confidence interval [CI] 1.02-2.11). Paresthesia was reported by 25% after radiation therapy to the SCLNs with a V40 Gy ≥ 13.5 cm(3), compared with 13% without radiation therapy, RR 1.83 (95% CI 1.13-2.95). Women having a maximum dose to the brachial plexus of ≥55.0 Gy had a 25% occurrence of paresthesia, with RR 1.86 (95% CI 0.68-5.07, not significant). CONCLUSION: Our results indicate that there is a correlation between larger irradiated volumes of the brachial plexus and an increased risk of reported paresthesia among women treated for breast cancer.
Authors: Laurence Leysen; David Beckwée; Jo Nijs; Roselien Pas; Thomas Bilterys; Sofie Vermeir; Nele Adriaenssens Journal: Support Care Cancer Date: 2017-08-10 Impact factor: 3.603
Authors: Soumon Rudra; Amit Roy; Randall Brenneman; Prashant Gabani; Michael C Roach; Laura Ochoa; Heidi Prather; Catherine Appleton; Julie Margenthaler; Lindsay L Peterson; Nusayba A Bagegni; Jacqueline E Zoberi; Jose Garcia-Ramirez; Maria A Thomas; Imran Zoberi Journal: Adv Radiat Oncol Date: 2020-10-27