Clinical efficacy of electrophysiological monitoring for patients with cancer-induced brachial plexus injury treated with 125I seeds therapy
10.3760/cma.j.cn321828-20230913-00047
- VernacularTitle:电生理监测 125I粒子治疗癌性臂丛神经损伤临床疗效的价值
- Author:
Xiaolu PEI
1
;
Zhen GAO
;
Linjing SONG
;
Yan DI
;
Lijuan ZHANG
;
Zezhou LIU
;
Hongtao ZHANG
Author Information
1. 河北省人民医院肿瘤科，石家庄 050051
- Keywords:
Brachial plexus neuropathies;
Neoplasms;
Brachytherapy;
Iodine radioisotopes;
Neurophysiological monitoring
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2024;44(9):545-548
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy of 125I seeds implantation in treating cancer-induced pain and motor dysfunction caused by brachial plexus compression through neurophysiological monitoring. Methods:A retrospective study was conducted on 8 patients (4 males, 4 females; age 58-63 years) who underwent 125I seeds therapy for cancer-induced brachial plexus injury at Hebei Provincial People′s Hospital from January 2021 to August 2023. Pain severity was assessed by using the numerical rating scale (NRS) and motor function was evaluated by using the Fugl-Meyer (F-M) assessment. Electrophysiological monitoring was used to assess changes in sensory and motor branch conduction velocity (CV) of the musculocutaneous nerve, axillary nerve, median nerve, ulnar nerve, and radial nerve before and 3 months after treatment. Paired t-test was used for data analysis. Results:All 8 patients had moderate to severe pain (6 had motor dysfunction). The preoperative and postoperative NRS scores was 5.9±1.0 and 3.3±1.7, respectively ( t=4.93, P=0.002), while F-M scores was 44.8±7.6 and 54.8±5.7, respectively ( t=-3.52, P=0.017). Electrophysiological results showed that 7 patients had lesion involvement in the lower trunk of the brachial plexus, and 1 patient had involvement in the upper trunk. The preoperative and postoperative motor branch CV of the ulnar nerve was (47.2±2.6) and (59.7±8.2) m/s, respectively ( t=-3.17, P=0.034), while the sensory branch CV was (41.8±1.2) and (56.0±5.7) m/s, respectively ( t=-5.82, P=0.001). The nerve CV increased compared to the preoperative ones. Conclusions:125I seeds implantation has good clinical efficacy in treating cancer-related pain and motor dysfunction caused by brachial plexus compression. Changes in electrophysiology can quantitatively monitor the recovery of sensory and motor functions of the brachial plexus.
