BRACHIAL PLEXOPATHY DUE TO THE ONCOLOGICAL RADIATION TREATMENT RELATED TO MALIGNANCY?

Abstract

Radiation-induced brachial plexopathy is a rare but well-known late complication of radiotherapy, typically manifesting several years after treatment. While its incidence is low, it is becoming more prevalent due to improved long-term cancer survival rates, predominantly affecting females. This condition is devastating, significantly altering the quality of life, as it often results in chronic disability that is progressive and usually irreversible. This study aims to present a 38-year single centre experience in the surgical treatment of radiation-induced brachial plexopathy. The study involved 92 female patients referred for potential surgical treatment of radiation-induced brachial plexopathy. Surgical candidates typically experienced progressive worsening of symptoms 4-6 months after onset, despite exhaustive conservative treatment. Diagnostic criteria included evident fibrosis on MRI or ultrasound and confirmation of plexopathy through electromyography. In total 37 patients were included, all females. Out of 92 cases, 37 were surgically treated due to plexopathy, all underwent external neurolysis, with 25 treated infraclavicularly and 12 both infraclavicular and supraclavicular. The overall functional recovery following surgery was useful, with a median outcome of M3. Post-surgery, 25 patients reported weakness, 31 experienced pain, 5 had lymphedema, and 23 had improved range of motion. Successfully treating patients with radiation-induced brachial plexopathy poses a significant challenge due to the progressive and often irreversible nature of the condition. Despite surgical interventions, achieving meaningful functional recovery is complex, with many patients continuing to experience persistent symptoms such as weakness and pain.

Keywords

• BRACHIAL PLEXOPATHY