ArticleClinical and translational radiation oncology2019
The radiation dose tolerance of the brachial plexus: A systematic review and meta-analysis.
Article in Clinical and translational radiation oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- Hypofractionated Stereotactic Radiation Therapy Dosimetric Tolerances for the Inferior Aspect of the Brachial Plexus: A Systematic Review.International journal of radiation oncology, biology, physics · 2024Pooled it
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- Radiation-Induced Brachial Plexopathy: Current Understanding, Diagnosis, and Treatment Options.Journal of hand surgery global online · 2026Review
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- Treatment of non-small cell lung cancer: advances following the introduction of PET-CT and IMRT/VMAT.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- Brachial Plexitis during Maintenance Atezolizumab after Palliative Radiotherapy for Cervical Spine Metastasis in Lung Cancer.Internal medicine (Tokyo, Japan) · 2025Article
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- Management of Stage IVB Cervical Cancer Including the Role of Radiotherapy.Current treatment options in oncology · 2025Review
- Evaluation of a simplified radiolabeling method for a PARP inhibitor in an animal model of breast cancer.EJNMMI research · 2025Article
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- Drug protection against radiation-induced neurological injury: mechanisms and developments.Archives of toxicology · 2025Review
- SPECT/CT Dosimetry of Bronchial ArteryRadiology · 2025Article
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- Comparative Evaluation of Proton Therapy and Volumetric Modulated Arc Therapy for Brachial Plexus Sparing in the Comprehensive Reirradiation of High-Risk Recurrent Breast Cancer.Advances in radiation oncology · 2024Article
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- Is there any radiation-induced brachial plexopathy after hypofractionated postmastectomy radiotherapy with helical tomotherapy?Frontiers in oncology · 2024Article
- Radiation induced brachial plexopathy in head and neck cancer patients treated with definitive radiotherapy and correlation with disease characteristics and dosimetric parameters.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2024Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe performed a systematic review and meta-analysis of studies reporting the incidence of radiation induced brachial plexopathy (RIBP) and the associated radiotherapy doses to this structure.
methodsDatabases were queried without language restriction for cohort studies reporting RIBP incidence and associated brachial plexus dose maximum dose (bpDmax). Studies specifying RIBP relative risk (RR) effect size were selected for meta-analysis. RRs for RIBP from each study were converted to a regression coefficient (β) and standard error corresponding to a continuous representation of bpDmax. The adjusted β from individual studies were combined using a random effects model and weighted by inverse variance (1/SE
resultsWe identified 25 studies that included 37 unique patient cohorts eligible for analysis. Seventeen cohorts experienced an RIBP incidence ≤5%, of which 6 cohorts exceeded conventional plexus constraints of 60 Gy for bpDmax. Five of the 6 cohorts were simulated with 3D-CT techniques. Meta-analysis of eligible studies demonstrated a significant increase in RIBP risk for each Gy increase in bpDmax (RR, 1.11; 95% CI 1.07-1.15). Results remained significant after adjustment for publication bias and when sensitivity analysis was performed.
conclusionsOur results suggest that current brachial plexus constraints of 60-66 Gy are safe. Meta-analysis provides a log-linear model to quantify the association of brachial plexus dose and RIBP risk, and thus inform the therapeutic ratio for dose escalation. Further prospective studies reporting dosimetric data can better refine this model and inform brachial plexus constraint guidelines.
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