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Title: Radiation Therapy to the Plexus Brachialis in Breast Cancer Patients: Analysis of Paresthesia in Relation to Dose and Volume

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 V{sub 40} {sub Gy} ≥ 13.5 cm{sup 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% CImore » 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.« less
Authors:
 [1] ;  [2] ;  [1] ;  [2] ;  [2] ;  [1] ;  [2] ;  [2] ;  [3] ;  [1] ;  [2] ;  [4] ;  [3] ;  [1]
  1. Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg (Sweden)
  2. (Sweden)
  3. Department of Therapeutic Radiation Physics, Sahlgrenska University Hospital, Gothenburg (Sweden)
  4. Regional Cancer Center, Sahlgrenska University Hospital, Gothenburg (Sweden)
Publication Date:
OSTI Identifier:
22458719
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 92; Journal Issue: 2; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; COMPARATIVE EVALUATIONS; COMPUTERIZED TOMOGRAPHY; CORRELATIONS; HAZARDS; IRRADIATION; LYMPH NODES; MAMMARY GLANDS; NEOPLASMS; PATIENTS; PLANNING; RADIATION DOSES; RADIOTHERAPY; SURGERY; WOMEN