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Radiation-Induced Lumbosacral Radiculopathy: A Comprehensive Clinical and Dosimetric Study
Zineb Dahbi1,2, Reyzane El Mjabber1,2, Amal Bouziyane3,4
1Radiation Oncology, Mohammed VI University of Sciences and Health, Casablanca, MAR.
Cureus
|January 30, 2026
Summary
Higher radiation doses to the lumbosacral plexus (LSP) are linked to radiation-induced lumbosacral plexopathy (RILP) after pelvic radiotherapy. Gender and diabetes also predict RILP, emphasizing the need for individualized dose constraints.
Area of Science:
- Radiation oncology
- Neurology
- Medical physics
Background:
- Radiation-induced lumbosacral radiculopathy (RILP) is an under-recognized complication of pelvic radiotherapy.
- It can cause long-term neurological deficits and impact quality of life.
Purpose of the Study:
- To investigate the association between radiation dose distribution to the lumbosacral plexus (LSP) and the occurrence of RILP.
- To identify predictive factors for RILP.
Main Methods:
- Retrospective analysis of 175 cancer-free patients post-pelvic radiotherapy.
- Lumbosacral plexus (LSP) delineation on CT/MRI scans.
- Dosimetric analysis of treatment plans and correlation with Oswestry Disability Index (ODI) scores.
Main Results:
- RILP (Grade 3) was observed in 13% of patients.
- Higher median maximum LSP dose (72.1 Gy vs. 60.2 Gy) and greater LSP volume overlap with the planning target volume (54.5% vs. 18.4%) were associated with RILP.
- Male gender and pre-existing diabetes were also predictive factors.
Conclusions:
- Increased radiation dose to the LSP, particularly Dmax and high-dose volume, significantly correlates with RILP.
- LSP should be considered an organ at risk in pelvic radiotherapy planning.
- Individualized dose constraints are crucial for minimizing neurological toxicity.
Keywords:
dosimetric analysislumbosacral plexopathypelvic radiotherapyquality of liferadiation toxicityMore Related Videos
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