Neurological AdverseEffects after Radiation Therapyfor Stage II Seminoma

Neurological AdverseEffects after Radiation Therapyfor Stage II Seminoma

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We report 3 cases of patients with testicular cancer and stage II seminoma who developed neurological symptoms with bilateral leg weakness about 4 to 9 months after radiation therapy EARACHE RELIEF (RT).They all received RT to the para-aortic lymph nodes with a total dose of 40 Gy (36 Gy + 4 Gy as a boost against the tumour bed) with a conventional fractionation of2 Gy/day, 5 days per week.RT was applied as hockey-stick portals, also called L-fields.In 2 cases, the symptoms fully resolved.Therapeutic irradiation can cause significant injury to the peripheral nerves of the lumbosacral plexus and/or to the spinal cord.

RT is believed to produce plexus injury by both direct toxic effects and secondary microinfarction of the nerves, but the exact pathophysiology of RT-induced injury is unclear.Since Knock Box reported studies of radiation-induced neurological adverse effects are limited, it is difficult to estimate their frequency and outcome.The treatment of neurological symptoms due to RT is symptomatic.