[Post-irradiation lesions of the brachial plexus]

A series of 60 cases in which a departure was made from the usual chronological distribution of preoperative radiation doses for breast cancer is presented. Tardive lesions were noted in the brachial plexus in 33 cases. Their incidence was higher in patients who had received larger dose fractions over a shorter total period. The progress of these lesions was barely influenced by medical and physical management. The underlying pathogenetic problems are examined, with particular reference to the radiotherapeutic technique and dose fractionation. Agreement is expressed with the opinion of other workers that the risk of such lesions can be kept down by employing a scrupulously careful technique, and employing total doses of 4.500-5.500 rads in 5-6 weeks. The conventional pattern of 5 weekly sessions should not be too widely departed from.