Dose–Volume Modeling of Brachial Plexus-Associated Neuropathy After Radiation Therapy for Head-and-Neck Cancer: Findings From a Prospective Screening Protocol

Chen, A.M.; Wang, P.; Daly, M.E.; Jin, Cui; Hall, William H.; Vijayakumar, Srinivasan; Phillips, Tiffany; Farwell, G.; Purdy, James A.

doi:10.1016/j.ijrobp.2013.11.191

Cited by 30 publications

(1 citation statement)

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“…Radiation in combination with neck dissection may lead to neck fibrosis, producing shoulder and neck stiffness, lymphedema, and trismus. 84 In severe cases, fibrosis and direct damage to nerves (often in areas with gross disease that receive more intensive treatment) may produce brachial plexopathy, 85 which may also occur with apical lung tumors and, rarely, with breast cancer treatment (<2% absent tumor-related factors). 86 Physical therapy incorporating jaw exercises and massage/manual drainage are important and are incorporated early in post-RT follow-up.…”

Section: Ototoxicitymentioning

confidence: 99%

Radiation therapy‐associated toxicity: Etiology, management, and prevention

Wang

Tepper

2021

CA A Cancer J Clinicians

193

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Radiation therapy (RT) is a curative treatment for many malignancies and provides effective palliation in patients with tumor-related symptoms. However, the biophysical effects of RT are not specific to tumor cells and may produce toxicity due to exposure of surrounding organs and tissues. In this article, the authors review the clinical context, pathophysiology, risk factors, presentation, and management of RT side effects in each human organ system. Ionizing radiation works by producing DNA damage leading to tumor death, but effects on normal tissue may result in acute and/or late toxicity. The manifestation of toxicity depends on both cellular characteristics and affected organs' anatomy and physiology. There is usually a direct relationship between the radiation dose and volume to normal tissues and the risk of toxicity, which has led to guidelines and recommended dose limits for most tissues. Side effects are multifactorial, with contributions from baseline patient characteristics and other oncologic treatments. Technological advances in recent decades have decreased RT toxicity by dramatically improving the ability to deliver RT that maximizes tumor dose and minimizes organ dose. Thus the study of RT-associated toxicity is a complex, core component of radiation oncology training that continues to evolve alongside advances in cancer management. Because RT is used in up to one-half of all patients with cancer, an understanding of its acute and late effects in different organ systems is clinically pertinent to both oncologists and nononcologists.

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Section: Ototoxicitymentioning

confidence: 99%

Radiation therapy‐associated toxicity: Etiology, management, and prevention

Wang

Tepper

2021

CA A Cancer J Clinicians

193

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Altered upper limb motor behavior in breast cancer survivors and its relation to pain: A narrative review

Baets

Vets

Emmerzaal

et al. 2022

The Anatomical Record

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Breast cancer is the most commonly diagnosed cancer among women and many women suffer from persistent physical and psychological complaints following their cancer treatment. Altered motor behavior at the shoulder region and upper limb, that is, alterations in movement patterns, spatiotemporal movement characteristics and muscle activation patterns, is a common physical consequence of breast cancer treatment, that can have a clear impact on daily life functioning and quality of life. Furthermore, altered upper limb motor behavior is suggested to relate to upper limb pain, which is very commonly reported in breast cancer survivors (BCS). This review, prepared according to the SANRA guidelines, looks into the current understanding of alterations in motor behavior at shoulder and upper limb in BCS, by discussing the factors related to this altered behavior. In this, we specifically focus on the relation between motor behavior and pain. Results of our search show that cancer treatment modality is predictive for shoulder range of motion. Furthermore, single prospective studies show depressive symptoms, living alone, being non‐white and low physical activity levels as predicting factors for reduced shoulder range of motion. Pain as factor related to altered motor behavior is only assessed in cross‐sectional research, limiting its interpretation in context of being cause or consequence of motor behavioral adaptations, and on the underlying mechanism explaining their relation. It is concluded that studies which explain the mechanisms how and in which subgroup of BCS motor behavioral alterations are associated with pain at the upper limb, are necessary in future.

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Assessment of neuropathic pain following cancer treatment

Moloney

Lenoir

2023

The Anatomical Record

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Neuropathic cancer pain (NCP) is prevalent affecting up to 58% of those with persistent pain following cancer treatment. Neuropathic pain can develop from malignancy, after neural tissue insult during surgery and/or exposure to radiation or neurotoxic agents used as part of cancer treatment regimens. Pain following cancer treatment is commonly under‐treated and one barrier identified is poor recognition of pain and inadequate assessment. Recognition of the presence of NCP is important to inform pain management, which is challenging to treat and warrants the use of specific treatments to target neuropathic mechanisms. In this review, approaches for screening and classifying NCP are described. These include screening questionnaires and the application of the updated neuropathic pain grading system in a cancer context. The evidence from neuropathic pain related assessments in cancer populations is provided and highlighted under different neuropathic pain grades. Recommendations for assessment in practice are provided.

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Dose–Volume Modeling of Brachial Plexus-Associated Neuropathy After Radiation Therapy for Head-and-Neck Cancer: Findings From a Prospective Screening Protocol

Cited by 30 publications

References 0 publications

Radiation therapy‐associated toxicity: Etiology, management, and prevention

Radiation therapy‐associated toxicity: Etiology, management, and prevention

Altered upper limb motor behavior in breast cancer survivors and its relation to pain: A narrative review

Assessment of neuropathic pain following cancer treatment

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