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Rehab opportunities in radiation fibrosis syndrome

How can we prevent lifelong dysfunction?

Radiation treatment for cancer is very effective in killing cancer cells and often used as adjuvant therapy post-surgery.

Toxicity may be acute (burnt skin, cough, pains) but can also present years later as a progressive condition called radiation fibrosis syndrome (RFS). 

RFS can affect any tissue type, including the skin, ligament, tendon, muscles, viscera, nerve, as well as lungs, the gastrointestinal and genitourinary tracts, bone, or other organs, depending upon the treatment site.

Rehabilitation of RFS has to be a complex procedure consisting of education, physical therapy, occupational therapy, orthotics as well as medication. Education on basic physiopathology and interrelationship of complaints is the starting point.

Physical therapy:

  • Physical activity during and after RT
  • Optimize ROM and muscle strength, life long
  • Synergistic muscle exercises, postural retraining, core strengthening
  • Fascial techniques
  • Myofascial relaxation techniques

 

Orthotics:

  • Neck collars as energy conservation device in cervical weakness
  • Ankle foot orthoses for plantar flexion weakness
  • Upper extremity orthotics for plexopathy
  • Knee-immobilizers


Medication:

Treatment of (neuropathic) pain and muscle spasms: pregabalin, NSAIDs, opoids and baclofen, benzodiapines are discussed.

 

Novel therapeutic approaches, particularly the combination of pentoxifylline and vitamin E and hyperbaric oxygen treatment is a promising modality, but not available world wide yet.

> From: Hojan et al., Rep Pract Oncol Radiother 19 (2014) 1-6 (Epub ahead of print). All rights reserved to Greater Poland Cancer Centre.. Click here for the online summary.

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