Radiation Oncology/Toxicity/Nerves

Peripheral Nerve Toxicity

Early-Delayed Plexopathy

Acute lumbosacral plexopathy

Development of pelvic pain or neuropathy.

• Sweden (Uppsala); 1996 (1979-94) PMID 8966224 -- "Acute lumbosacral plexopathy during and after preoperative radiotherapy of rectal adenocarcinoma." (Frykholm GJ, Radiother Oncol. 1996 Feb;38(2):121-30.)
  • Investigated development of acute pain or paresthesias (in the back, gluteal region, or legs) beginning during RT. Some with long lasting or permanent symptoms.
  • 5 Gy x 5 daily. 550 pts treated. 3 field (PA + posterior obliques) technique. Superior border at mid-L3 to mid-L4.
  • In the early treatment period (1979-1992), 11 pts of 443 (2%) developed pain. In 1993, there was an increase in the number of patients with pain, 15 of 29 (25%).
  • No obvious cause in the increase seen in 1993. Subsequently, treatment modified to a 4-field technique for improved homogeneity and upper border lowered to mid-L5.