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Electrophysiologic evidence of subclinical injury to the posterior columns of the human spinal cord after therapeutic radiation
Author(s) -
Dorfman Leslie J.,
Donaldson Sarah S.,
Gupta Pramila R.,
Bosley Thomas M.
Publication year - 1982
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19821215)50:12<2815::aid-cncr2820501221>3.0.co;2-p
Subject(s) - medicine , spinal cord , subclinical infection , nerve conduction velocity , anesthesia , cord , radiation therapy , latency (audio) , nuclear medicine , surgery , psychiatry , electrical engineering , engineering
Spinal somatosensory conduction velocity (SSCV) was indirectly estimated from cerebral evoked potentials in 15 adults who had received therapeutic radiation (RT) (2000–4380 rad) to the thoracic spinal cord during treatment for lung cancer, and in 15 age‐matched normal controls. Thirteen of the patients had also received 4400–5500 rad to the supraclavicular fossae. One‐way impulse conduction time in the arm, estimated from F‐wave latency, was prolonged in the patients as compared to controls (12.0 ± 1.2 versus 10.4 ± 1.0 msec; P < 0.001) but conduction time in the leg was similar in the two groups (22.4 ± 2.4 versus 22.0 ± 2.5 msec; P > 0.1). SSCV was significantly slower in the patient group (37.9 ± 13.9 versus 54.5 ± 12.9 m/sec; P < 0.001) whereas supraspinal latency (cervical cord to cortex) was identical (5.5 ± 0.9 versus 5.5 ± 0.8 msec; P > 0.1). SSCV in the patient group was not related to total RT dose (r = 0.15; P = 0.2), but was correlated with both treatment time and number of fractions (r = 0.49 and 0.43; P = 0.003 and 0.007, respectively). These findings suggest that RT may produce subclinical spinal cord dysfunction even at conventional dosage schedules, and that it may be possible physiologically to monitor the myelopathic effects of RT in individual patients.