Radiation Fibrosis Syndrome: The Evergreen Menace of Radiation Therapy

Abstract

Fibrosis is a descriptive appellation referring to the obliteration of normal tissue components replaced by matrix and disorganized and varied collagen fibrils that result in the loss of organ function and frequent tissue contraction leading to death or significant deterioration in the quality of life. Radiation fibrosis syndrome (RFS) is a progressive fibrotic tissue sclerosis with various clinical symptoms in the irradiation field. It is usually a late complication of radiation therapy and may occur weeks or even years after treatment. It may affect the musculoskeletal, soft tissue, neural tissue, and cardiopulmonary systems. RFS is a serious and lifelong disorder that, nevertheless, may often be prevented when identified and rehabilitated early. Genetic factors likely play a significant role in the development of chronic fibrotic response to radiation injury that persists even after the initial insult is no longer present. Management of this syndrome is a complex process comprising medication, education, rehabilitation, and physical and occupational therapy. A bibliographical search was carried out in PubMed using the following keywords: “radiation fibrosis,” “radiation fibrosis syndrome,” and “radiation-induced fibrosis.” We also reviewed the most relevant and recent series on the current management of RFS, and the reviewed data are discussed in this article. This review discusses the pathophysiology, evaluation, and treatment of neuromuscular, musculoskeletal, and functional disorders as late effects of radiation treatment.

Predictive Factors of Non-Response to Vismodegib in Locally Advanced Basal-Cell Carcinoma

“…As suggested in our study, one of the predictors of poor response to vismodegib was a history of prior radiotherapy. In this respect, results of the literature are conflicting [7, 17, 18]. In the study of Chang et al [7] including 62 patients with laBCC treated with vismodegib, objective response rate was not significantly decreased in patients with prior radiotherapy ( n = 20), and the European guidelines for BCC management recommended radiotherapy as first line in patients non-eligible to surgery.…”

Autotaxin and Breast Cancer: Towards Overcoming Treatment Barriers and Sequelae

“…Fibrosis is a common morbidity associated with RT such that RT for head and neck, thoracic, and pelvic cancers is restricted because of this [134]. Collectively, the constellation of symptoms from RT fibrosis is termed Radiation Fibrosis Syndrome [135]. RT to the whole breast after lumpectomy results in Grade 1 fibrosis in~27% of patients at 3 years and Grade 2 fibrosis in~1% [136].…”

Sonographic Pearls for Imaging the Brachial Plexus and Its Pathologies

“…Brachial plexopathy may develop after months to years after radiation therapy [15]. It is more likely to occur in patients radiated for breast, lung, head, and neck tumors.…”