Early transient radiation-induced brachial plexopathy in locally advanced head and neck cancer.

ABSTRACT

AIM OF THE STUDY Early transient brachial plexopathy following radiotherapy (RT) in patients with head and neck cancer may be underreported and associated with a dose-response. Our purpose was to determine the incidence of early transient radiation-induced brachial plexopathy (RIBP) in patients receiving primary RT (± chemotherapy) for locally advanced head and neck cancer (HNC). MATERIAL AND METHODS: Twenty-seven locally advanced HNC patients who have no finding of brachial plexopathy at the diagnosis were evaluated 3 times by a specifically developed 13-item questionnaire for determining early transient RIBP. The 54 brachial plexus in 27 patients were delineated and dose volume histograms were calculated. RESULTS: Median follow-up period was 28 (range 15-40) months. The mean BP volume was 7.9 ±3.6 cm(3), and the mean and maximum doses to the BP were 45.3 (range 32.3-59.3) Gy, and 59.4 (range 41.4-70.3) Gy, respectively. Maximum dose to the BP was ≥ 70 Gy only in 2 nasopharyngeal cancer patients. Two (7%) early transient RIBP were reported at 7(th) and 8(th) month after RT under maximum 67.17 and 55.37 Gy, and mean 52.95 and 38.60 Gy RT doses. CONCLUSIONS: Two (7%) early RIBP were seen in the patient group, although brachial plexus maximum doses were ≥ 66 Gy in 75% of patients.