Twelve patients who developed
radiation-induced brachial plexopathy (RIBP) after receiving
radiation therapy for
breast carcinoma (7 patients) or
Hodgkin's lymphoma (5 patients) were followed for 12 or more years, with a mean follow-up time of 20 years. Tingling and
numbness of the fingers as well as weakness of the hand or arm were the most prominent presenting symptoms of RIBP. Whereas
pain in most patients evolved only later in the course, it became a predominant feature in only 2. In 8 of the 12 patients, the plexopathy was surgically treated, either by neurolysis only or by neurolysis plus omental grafting in order to stop progression or
paresis and/or
pain. In 8 patients, including 6 of the operated group, there was slow and steady progression of RIBP over time, with the final outcome being almost complete
paralysis of the arm (2 patients) or severe sensorimotor
paresis rendering the hand useless (6 patients). In only 4 patients, including 2 of the non-operated group, was there absence of progression and stabilization of the
paresis with only slight functional loss of the affected arm in 3 patients and severe
palsy in 1. None of the 12 patients had any clear long-lasting improvement of their sensorimotor impairment. It is concluded from this study that RIBP, irrespective of surgery (neurolysis and/or omentum transplant), left two-thirds of the patients with severe or total
paresis of the arm. However, the almost complete relief of severe
pain (6 of 8 patients), both immediately and in follow-up patients treated with neurolysis and/or omental transplant, indicates that surgical treatment has a beneficial effect on
pain relief.