Six-Fraction Ultra-Hypofractionated Radiotherapy for Tumours Adjacent to or Involving the Brachial Plexus: A Retrospective Cohort Study.
- 1Department of Radiation Oncology, University Teaching Hospital Luzern, Spitalstrasse, 6004 Luzern, Switzerland.
- 2Medical Physics, Radiotherapy Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland.
Abstract
Background/Objectives: Tumours abutting or involving the brachial plexus can cause pain and neurological deficits. We evaluated six-fraction ultra-hypofractionated radiotherapy with a simultaneous integrated boost (uhRT-SIB) in a predominantly palliative cohort. Methods: We retrospectively analysed consecutive patients treated from April 2022 to June 2026, with a data cut-off of 7 July 2026. Image-guided VMAT delivered 33 Gy and 24 Gy to the high- and lower-dose planning target volumes, respectively. Outcomes included the best documented CTCAE-based symptom response, study-defined volumetric response (>30% GTV reduction), freedom from local progression (FFLP), overall survival (OS), and neurological findings in routine clinical records. Results: Forty-four patients with 45 lesions were treated; 29/45 lesions (64.4%) contacted the plexus. The median observed follow-up was 7.8 months (range 0.6-40.6). Symptoms improved by at least one grade in 16/19 evaluable symptomatic patients (84.2%, 95% CI 62.4-94.5%). The median times to first documented benefit and best symptom grade among responders were 9 and 23 days. The first-scan volumetric response occurred in 24/30 evaluable lesions (80.0%, 95% CI 62.7-90.5%). Six- and 12-month FFLP were 84.7% (95% CI 63.9-94.0%) and 73.7% (95% CI 49.7-87.6%), respectively. The median OS was 9.6 months. No clinical diagnosis of radiation-induced brachial plexopathy was documented; neurological assessment was not standardised. Conclusions: In this predominantly palliative cohort, six-fraction uhRT-SIB was associated with symptom improvement in 84.2% of evaluable symptomatic patients, study-defined volumetric response in 80.0% of evaluable lesions, and 12-month FFLP of 73.7%. No clinical diagnosis of radiation-induced brachial plexopathy was documented during routine follow-up, although the assessment of late neurological toxicity was limited.
Related
- Feasibility of Urethra-Sparing Ultra-Hypofractionated Three-Dose-Level Radiotherapy for Prostate Cancer with a Dominant Intraprostatic Lesion Abutting the High-Dose Avoidance Zone.
- Efficacy and safety of single-fraction stereotactic body radiotherapy (SBRT) for the curative treatment of extracranial primary Tumors: A collaborative systematic review on behalf of the SBRT Focus Group of the European Society for Radiotherapy & Oncology (ESTRO).
- 3D analysis and evolution of prostate and tumor oxygenation using MRI-derived relative oxygen extraction fraction during MR-guided stereotactic body radiotherapy☆
- Dosimetric Comparison of Intensity-Modulated Radiotherapy and Four-Field Three-Dimensional Conformal Radiotherapy in the Management of Prostate Cancer: A Retrospective Dual-Centre Analysis
- EQD2-adjusted mean lung dose and symptomatic pneumonitis after thoracic radiotherapy following immune checkpoint inhibitors in lung cancer: a single-center retrospective cohort study
BibTeX
@article{sturz2026sixfraction,
title = {{Six-Fraction Ultra-Hypofractionated Radiotherapy for Tumours Adjacent to or Involving the Brachial Plexus: A Retrospective Cohort Study.}},
author = {Maximilian Sturz and Gabriela Studer and Christoph Glanzmann and Sergejs Unterkirhers and Philippe Logaritsch and Olga Unterkirhere},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18193189},
url = {https://europepmc.org/article/MED/42882883},
note = {CC BY},
}
RIS
TY - JOUR
TI - Six-Fraction Ultra-Hypofractionated Radiotherapy for Tumours Adjacent to or Involving the Brachial Plexus: A Retrospective Cohort Study.
AU - Maximilian Sturz
AU - Gabriela Studer
AU - Christoph Glanzmann
AU - Sergejs Unterkirhers
AU - Philippe Logaritsch
AU - Olga Unterkirhere
PY - 2026
DA - 2026/10/02
JO - Cancers
DO - 10.3390/cancers18193189
UR - https://europepmc.org/article/MED/42882883
AB - Background/Objectives: Tumours abutting or involving the brachial plexus can cause pain and neurological deficits. We evaluated six-fraction ultra-hypofractionated radiotherapy with a simultaneous integrated boost (uhRT-SIB) in a predominantly palliative cohort. Methods: We retrospectively analysed consecutive patients treated from April 2022 to June 2026, with a data cut-off of 7 July 2026. Image-guided VMAT delivered 33 Gy and 24 Gy to the high- and lower-dose planning target volumes, respectively. Outcomes included the best documented CTCAE-based symptom response, study-defined volumetric response (>30% GTV reduction), freedom from local progression (FFLP), overall survival (OS), and neurological findings in routine clinical records. Results: Forty-four patients with 45 lesions were treated; 29/45 lesions (64.4%) contacted the plexus. The median observed follow-up was 7.8 months (range 0.6-40.6). Symptoms improved by at least one grade in 16/19 evaluable symptomatic patients (84.2%, 95% CI 62.4-94.5%). The median times to first documented benefit and best symptom grade among responders were 9 and 23 days. The first-scan volumetric response occurred in 24/30 evaluable lesions (80.0%, 95% CI 62.7-90.5%). Six- and 12-month FFLP were 84.7% (95% CI 63.9-94.0%) and 73.7% (95% CI 49.7-87.6%), respectively. The median OS was 9.6 months. No clinical diagnosis of radiation-induced brachial plexopathy was documented; neurological assessment was not standardised. Conclusions: In this predominantly palliative cohort, six-fraction uhRT-SIB was associated with symptom improvement in 84.2% of evaluable symptomatic patients, study-defined volumetric response in 80.0% of evaluable lesions, and 12-month FFLP of 73.7%. No clinical diagnosis of radiation-induced brachial plexopathy was documented during routine follow-up, although the assessment of late neurological toxicity was limited.
SN - 2072-6694
ER -