breast radiation and neuropathy - to Martha

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Hi Martha,

I am so sorry you are having to undergo radiation. I have been searching

medline and came up with this: don't know if it give you any information

that you wanted.

1: Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1207-19

Dose response and latency for radiation-induced fibrosis, edema, and

neuropathy in breast cancer patients.

Johansson S, Svensson H, Denekamp J.

Department of Radiation Sciences, Translational Research Group, Umea

University Hospital, Sweden. silvia.johansson@...

PURPOSE: To study the incidence of various forms of late normal tissue

injuries to determine the latency and dose-response relationships.

METHODS:

We retrospectively analyzed the clinical records of 150 breast cancer

patients treated with radiotherapy after mastectomy in the mid to late

1960s. None of the patients had received chemotherapy as a part of their

primary treatment. Radiotherapy was delivered to the parasternal,

axillary, and supraclavicular lymph node regions. Almost all the

patients continued to be checked at regular 3-month to 1-year intervals

at our Oncology Department. Detailed records were available for the

entire 34 years of the follow-up period. The patients were divided into

3 groups. The prescribed dose was either 11 x 4 Gy (treated with 60Co

photons) or 11 x 4 Gy or 14-15 x 3 Gy (treated with both 60Co photons

and electrons). The dose recalculation at the brachial plexus where the

axillary and supraclavicular beams overlapped was performed in the early

1970s and expressed in cumulative radiation effect (CRE) units. It

varied

widely among the individual patients. The received dose has now been

converted to biologic effective dose(3) units, and from that into the

equivalent dose in 2-Gy fractions to plot the dose-response

relationships.

RESULTS:

We present a comparison of the latency and frequency of fibrosis, edema,

brachial plexus neuropathy, and paralysis in the three different

subgroups and the total group. Dose-response relationships are shown at

5, 10, and 30 years after irradiation.

CONCLUSION: The use of large daily fractions, combined with hotspots

from overlapping fields, was the cause of the complications. Clear

dose-response curves were seen for late radiation injuries. The

incidence seen at 5 years did not represent the full spectrum of

injuries. Doses that seem safe at 5 years can lead to serious

complications later.