Skip to main content
Journal cover image

Brachial plexopathy in apical non-small cell lung cancer treated with definitive radiation: dosimetric analysis and clinical implications.

Publication ,  Journal Article
Eblan, MJ; Corradetti, MN; Lukens, JN; Xanthopoulos, E; Mitra, N; Christodouleas, JP; Grover, S; Fernandes, AT; Langer, CJ; Evans, TL ...
Published in: International journal of radiation oncology, biology, physics
January 2013

Data are limited on the clinical significance of brachial plexopathy in patients with apical non-small cell lung cancers (NSCLC) treated with definitive radiation therapy. We report the rates of radiation-induced brachial plexopathy (RIBP) and tumor-related brachial plexopathy (TRBP) and associated dosimetric parameters in apical NSCLC patients.Charts of NSCLC patients with primary upper lobe or superiorly located nodal disease who received ≥50 Gy of definitive conventionally fractionated radiation or chemoradiation were retrospectively reviewed for evidence of brachial plexopathy and categorized as RIBP, TRBP, or trauma-related. Dosimetric data were gathered on ipsilateral brachial plexuses (IBP) contoured according to Radiation Therapy Oncology Group atlas guidelines.Eighty patients were identified with a median follow-up and survival time of 17.2 and 17.7 months, respectively. The median prescribed dose was 66.6 Gy (range, 50.4-84.0), and 71% of patients received concurrent chemotherapy. RIBP occurred in 5 patients with an estimated 3-year rate of 12% when accounting for competing risk of death. Seven patients developed TRBP (estimated 3-year rate of 13%), comprising 24% of patients who developed locoregional failures. Grade 3 brachial plexopathy was more common in patients who experienced TRBP than RIBP (57% vs 20%). No patient who received ≤78 Gy to the IBP developed RIBP. On multivariable competing risk analysis, IBP V76 receiving ≥1 cc, and primary tumor failure had the highest hazard ratios for developing RIBP and TRBP, respectively.RIBP is a relatively uncommon complication in patients with apical NSCLC tumors receiving definitive doses of radiation, while patients who develop primary tumor failures are at high risk for developing morbid TRBP. These findings suggest that the importance of primary tumor control with adequate doses of radiation outweigh the risk of RIBP in this population of patients.

Altmetric Attention Stats
Dimensions Citation Stats

Published In

International journal of radiation oncology, biology, physics

DOI

EISSN

1879-355X

ISSN

0360-3016

Publication Date

January 2013

Volume

85

Issue

1

Start / End Page

175 / 181

Related Subject Headings

  • Retrospective Studies
  • Radiotherapy Dosage
  • Radiation Injuries
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Disease-Free Survival
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Eblan, M. J., Corradetti, M. N., Lukens, J. N., Xanthopoulos, E., Mitra, N., Christodouleas, J. P., … Apisarnthanarax, S. (2013). Brachial plexopathy in apical non-small cell lung cancer treated with definitive radiation: dosimetric analysis and clinical implications. International Journal of Radiation Oncology, Biology, Physics, 85(1), 175–181. https://doi.org/10.1016/j.ijrobp.2012.03.051
Eblan, Michael J., Michael N. Corradetti, J Nicholas Lukens, Eric Xanthopoulos, Nandita Mitra, John P. Christodouleas, Surbhi Grover, et al. “Brachial plexopathy in apical non-small cell lung cancer treated with definitive radiation: dosimetric analysis and clinical implications.International Journal of Radiation Oncology, Biology, Physics 85, no. 1 (January 2013): 175–81. https://doi.org/10.1016/j.ijrobp.2012.03.051.
Eblan MJ, Corradetti MN, Lukens JN, Xanthopoulos E, Mitra N, Christodouleas JP, et al. Brachial plexopathy in apical non-small cell lung cancer treated with definitive radiation: dosimetric analysis and clinical implications. International journal of radiation oncology, biology, physics. 2013 Jan;85(1):175–81.
Eblan, Michael J., et al. “Brachial plexopathy in apical non-small cell lung cancer treated with definitive radiation: dosimetric analysis and clinical implications.International Journal of Radiation Oncology, Biology, Physics, vol. 85, no. 1, Jan. 2013, pp. 175–81. Epmc, doi:10.1016/j.ijrobp.2012.03.051.
Eblan MJ, Corradetti MN, Lukens JN, Xanthopoulos E, Mitra N, Christodouleas JP, Grover S, Fernandes AT, Langer CJ, Evans TL, Stevenson J, Rengan R, Apisarnthanarax S. Brachial plexopathy in apical non-small cell lung cancer treated with definitive radiation: dosimetric analysis and clinical implications. International journal of radiation oncology, biology, physics. 2013 Jan;85(1):175–181.
Journal cover image

Published In

International journal of radiation oncology, biology, physics

DOI

EISSN

1879-355X

ISSN

0360-3016

Publication Date

January 2013

Volume

85

Issue

1

Start / End Page

175 / 181

Related Subject Headings

  • Retrospective Studies
  • Radiotherapy Dosage
  • Radiation Injuries
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Disease-Free Survival