Open Access

Manfred Stöhr

• This chapter discusses delayed radiotherapy injury to the peripheral nervous system, which may affect any peripheral or cranial nerve within the radiotherapy field. Injury to the brachial plexus is the most frequent complication of radiotherapy to the peripheral nervous system. The actuarial incidence of a radiation-induced brachial plexus injury in 449 breast cancer patients was 4.9% after 5.5 years of therapy. The pathogenesis of radiogenic injury involves direct injury by radiation to the various cellular elements constituting the peripheral nerves such as the Schwann cells. There is secondary damage to the same cells and axon processes from the late angiomesenchymal changes. To date there are no proven strategies for treating postradiation injury of the peripheral nerves. Basic treatment includes physiotherapy to prevent and treat joint contractures, strength training, the reduction and prevention of any further tissue swelling, and the prevention of lymphedema. Injections orThis chapter discusses delayed radiotherapy injury to the peripheral nervous system, which may affect any peripheral or cranial nerve within the radiotherapy field. Injury to the brachial plexus is the most frequent complication of radiotherapy to the peripheral nervous system. The actuarial incidence of a radiation-induced brachial plexus injury in 449 breast cancer patients was 4.9% after 5.5 years of therapy. The pathogenesis of radiogenic injury involves direct injury by radiation to the various cellular elements constituting the peripheral nerves such as the Schwann cells. There is secondary damage to the same cells and axon processes from the late angiomesenchymal changes. To date there are no proven strategies for treating postradiation injury of the peripheral nerves. Basic treatment includes physiotherapy to prevent and treat joint contractures, strength training, the reduction and prevention of any further tissue swelling, and the prevention of lymphedema. Injections or infusions into the affected limb must be avoided, as well as major injuries or extensive use of the affected limb.…