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Radiculopatía Lumbosacra Inducida por Radiación: Un Estudio Clínico y Dosimétrico Integral

Zineb Dahbi^1,2, Reyzane El Mjabber^1,2, Amal Bouziyane^3,4

¹Radiation Oncology, Mohammed VI University of Sciences and Health, Casablanca, MAR.

|January 30, 2026

Resumen

Dosis más altas de radiación al plexo lumbosacro (PL) se asocian con plexopatía lumbosacra inducida por radiación (PLIR) después de radioterapia pélvica. El género y la diabetes también predicen la PLIR, lo que enfatiza la necesidad de restricciones de dosis individualizadas.

Área de la Ciencia:

Oncología radioterápica; Neurología; Física médica

Sus antecedentes:

La radiculopatía lumbosacra inducida por radiación (RLIR) es una complicación poco reconocida de la radioterapia pélvica. Puede causar déficits neurológicos a largo plazo e impactar la calidad de vida.

Objetivo del estudio:

Investigar la asociación entre la distribución de la dosis de radiación al plexo lumbosacro (PL) y la aparición de PLIR. Identificar los factores predictivos de PLIR.

Principales métodos:

Análisis retrospectivo de 175 pacientes sin cáncer después de radioterapia pélvica. Delineación del plexo lumbosacro (PL) en exploraciones de TC/RM. Análisis dosimétrico de los planes de tratamiento y correlación con las puntuaciones del Índice de Discapacidad de Oswestry (IDO).

Principales resultados:

Se observó PLIR (Grado 3) en el 13% de los pacientes. Una dosis máxima de PL más alta (72,1 Gy frente a 60,2 Gy) y un mayor solapamiento del volumen del PL con el volumen objetivo de planificación (54,5 % frente a 18,4 %) se asociaron con PLIR. El género masculino y la diabetes preexistente también fueron factores predictivos.

Conclusiones:

El aumento de la dosis de radiación al PL, particularmente Dmax y el volumen de alta dosis, se correlaciona significativamente con la RLIR. El PL debe considerarse un órgano en riesgo en la planificación de la radioterapia pélvica. Las restricciones de dosis individualizadas son cruciales para minimizar la toxicidad neurológica.

Palabras clave:

análisis dosimétrico plexopatía lumbosacra radioterapia pélvica calidad de vida toxicidad por radiación

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