TURKISH JOURNAL OF ONCOLOGY
2008 , Vol 23 , Num 3
Pathophysiology and management of radiation-induced lumbosacral plexopathy
Başkent Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, Adana
Radiation-induced lumbosacral plexopathy (RILP) is a rare
but severely debilitating side effect of abdominopelvic irradiation,
which is used in the management of a myriad of primary
and metastatic tumors involving the abdominal, pelvic
and retroperitoneal regions. Although the exact mechanism of
RILP is not yet clearly elucidated, postulated mechanisms
include radiation-induced vascular injury and radiation fibrosis
leading to axonal damage and entrapment of nerves/small
vessels, respectively. Effects of radiation are suggested to be
correlated to the dose per fraction and total dose of radiation
therapy (RT), use of radiosensitizing agents, RT technique,
and concurrent administration of chemotherapy. Furthermore,
the risk of RILP occurrence particularly increases with intracavitary
and intraoperative brachytherapy applications. In the
current review, we aimed to summarize the latest literature
considering aspects of the pathophysiology, clinical features
differential diagnosis, and treatment of this debilitating complication.
Keywords :
Pathophysiology; radiation-induced lumbosacral plexopathy; treatment