Pathophysiology and Treatment of Radiation-Induced Brachial Plexopathy

Radiation therapy is a well proven effective treatment modality in the management of various cancers. However, radiation therapy has potentially adverse effects on several tissues including central and peripheral nervous systems. Radiation-induced brachial plexopathy is a rare but challenging complication of RT in patients undergoing chest, axillary, and neck irradiation because of myriad of primary or malignant tumors of these region. It is a progressive disease state which may lead to devastating sensorial and motor malfunctions. Currently. there is no generally accepted treatment method, but non-narcotic and narcotics and anesthetic interventions for grade 1 and 2 lesions are suggested. In grade 3 and 4 injuries, surgical interventions to prevent fibrosis of the vascular supply to the nerves and to release nerves from fibrotic constrictions should be considered.