Neuromuscular Complications of Radiation Fibrosis Syndrome

Purpose of Review Radiation fibrosis syndrome (RFS) can adversely affect the function and quality of life of cancer survivors. This paper summarizes the neuromuscular complications of RFS and common clinical manifestations in the patient groups most commonly affected including those treated for Hodgkin’s lymphoma, head and neck cancer, and breast cancer. Recent Findings A wide range of clinical sequelae can be seen in RFS including myelopathy, radiculopathy, plexopathy, neuropathy, myopathy, or any combinations of these disorders, a phenomenon termed “ myelo-radiculo-plexo-neuro-myopathy .” Shoulder dysfunction, dropped head syndrome, cervical dystonia, and trismus are commonly seen as well. Managing the neuromuscular sequelae of RFS is generally conservative and relies heavily on specialized physical and occupational therapy. Comprehensive pain management, including the use of injections such as botulinum toxin, is key to achieving optimal clinical outcomes. Summary Neuromuscular complications post-radiation treatment can limit function and quality of life for cancer survivors, especially for those with Hodgkin’s lymphoma, head and neck, and breast cancer. Physiatrists managing these complex populations should understand the basic pathophysiology underlying their functional disorders as well as the principles of safe, effective, and compassionate life-long rehabilitation.