ArticleRadiation oncology (London, England)2018
Identifying risk factors for L'Hermitte's sign after IMRT for head and neck cancer.
Article in Radiation oncology (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Prognostic models for radiation-induced complications after radiotherapy in head and neck cancer patients.The Cochrane database of systematic reviews · 2025Pooled it
- Long-term outcomes and patient profiles following intensity-modulated radio-chemotherapy for nasopharyngeal cancer in a nonendemic region.Frontiers in oncology · 2026Article
- Trimodality therapy of malignant pleural mesothelioma with helical tomotherapy.Northern clinics of Istanbul · 2023Article
- Head and neck cancer survivorship consensus statement from the American Head and Neck Society.Laryngoscope investigative otolaryngology · 2022Review
- Multiple sclerosis as differential diagnosis of radionecrosis for post-irradiation brain lesions: A case report.Clinical and translational radiation oncology · 2020Article
- Anatomical change during radiotherapy for head and neck cancer, and its effect on delivered dose to the spinal cord.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2019Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundL'Hermitte's sign (LS) after chemoradiotherapy for head and neck cancer appears related to higher spinal cord doses. IMRT plans limit spinal cord dose, but the incidence of LS remains high.
methodsOne hundred seventeen patients treated with TomoTherapy™ between 2008 and 2015 prospectively completed a side-effect questionnaire (VoxTox Trial Registration: UK CRN ID 13716). Baseline patient and treatment data were collected. Radiotherapy plans were analysed; mean and maximum spinal cord dose and volumes receiving 10, 20, 30 and 40 Gy were recorded. Dose variation across the cord was examined. These data were included in a logistic regression model.
resultsForty two patients (35.9%) reported LS symptoms. Concurrent weekly cisplatin did not increase LS risk (p = 0.70, OR = 1.23 {95% CI 0.51-2.34}). Of 13 diabetic participants (9 taking metformin), only 1 developed LS (p = 0.025, OR = 0.13 {95% CI 0.051-3.27}). A refined binary logistic regression model showed that patients receiving unilateral radiation (p = 0.019, OR = 2.06 {95% CI 0.15-0.84}) were more likely to develop LS. Higher V
conclusionsIn this cohort, concomitant cisplatin did not increase risk, and LS incidence was lower in diabetic patients. Patient age and dose gradients across the spinal cord may be important factors.
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