Incidence and predictors of Lhermitte's sign among patients receiving mediastinal radiation for lymphoma

Bassem Youssef; Jo Ann Shank; Jay P. Reddy; Chelsea C. Pinnix; George Farha; Mani Akhtari; Pamela K. Allen; Michelle A. Fanale; John A. Garcia; Patricia H. Horace; Sarah Milgrom; Grace Li Smith; Yago Nieto; Isadora Arzu; He Wang; Nathan Fowler; Maria Alma Rodriguez; Bouthaina Dabaja

doi:10.1186/s13014-015-0504-7

Incidence and predictors of Lhermitte's sign among patients receiving mediastinal radiation for lymphoma

Bassem Youssef, Jo Ann Shank, Jay P. Reddy, Chelsea C. Pinnix, George Farha, Mani Akhtari, Pamela K. Allen, Michelle A. Fanale, John A. Garcia, Patricia H. Horace, Sarah Milgrom, Grace Li Smith, Yago Nieto, Isadora Arzu, He Wang, Nathan Fowler, Maria Alma Rodriguez, Bouthaina Dabaja

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Abstract

Purpose: To prospectively examine the risk of developing Lhermitte's sign (LS) in patients with lymphoma treated with modern-era chemotherapy followed by consolidation intensity-modulated radiation therapy. Methods: We prospectively interviewed all patients with lymphoma who received irradiation to the mediastinum from July 2011 through April 2014. We extracted patient, disease, and treatment-related variables from the medical records of those patients and dosimetric variables from treatment-planning systems and analyzed these factors to identify potential predictors of LS with Pearson chi-square tests. Results: During the study period 106 patients received mediastinal radiation for lymphoma, and 31 (29%) developed LS. No correlations were found between LS and any of the variables examined, including total radiation dose, maximum point dose to the spinal cord, volume receiving 105% of the dose, and volumes receiving 5 or 15Gy. Conclusion: In this group of patients, treatment with chemotherapy followed by intensity-modulated radiation therapy led to 29% developing LS; this symptom was independent of radiation dose and seemed to be an idiosyncratic reaction. This relatively high incidence could have resulted from prospective use of a structured interview.

Original language	English (US)
Article number	206
Journal	Radiation Oncology
Volume	10
Issue number	1
DOIs	https://doi.org/10.1186/s13014-015-0504-7
State	Published - Sep 25 2015

ASJC Scopus subject areas

Oncology
Radiology Nuclear Medicine and imaging

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Youssef, B., Shank, J. A., Reddy, J. P., Pinnix, C. C., Farha, G., Akhtari, M., Allen, P. K., Fanale, M. A., Garcia, J. A., Horace, P. H., Milgrom, S., Smith, G. L., Nieto, Y., Arzu, I., Wang, H., Fowler, N., Rodriguez, M. A., & Dabaja, B. (2015). Incidence and predictors of Lhermitte's sign among patients receiving mediastinal radiation for lymphoma. Radiation Oncology, 10(1), Article 206. https://doi.org/10.1186/s13014-015-0504-7

Youssef, B, Shank, JA, Reddy, JP , Pinnix, CC, Farha, G, Akhtari, M, Allen, PK, Fanale, MA, Garcia, JA, Horace, PH, Milgrom, S, Smith, GL , Nieto, Y , Arzu, I , Wang, H, Fowler, N, Rodriguez, MA & Dabaja, B 2015, 'Incidence and predictors of Lhermitte's sign among patients receiving mediastinal radiation for lymphoma', Radiation Oncology, vol. 10, no. 1, 206. https://doi.org/10.1186/s13014-015-0504-7

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title = "Incidence and predictors of Lhermitte's sign among patients receiving mediastinal radiation for lymphoma",

abstract = "Purpose: To prospectively examine the risk of developing Lhermitte's sign (LS) in patients with lymphoma treated with modern-era chemotherapy followed by consolidation intensity-modulated radiation therapy. Methods: We prospectively interviewed all patients with lymphoma who received irradiation to the mediastinum from July 2011 through April 2014. We extracted patient, disease, and treatment-related variables from the medical records of those patients and dosimetric variables from treatment-planning systems and analyzed these factors to identify potential predictors of LS with Pearson chi-square tests. Results: During the study period 106 patients received mediastinal radiation for lymphoma, and 31 (29%) developed LS. No correlations were found between LS and any of the variables examined, including total radiation dose, maximum point dose to the spinal cord, volume receiving 105% of the dose, and volumes receiving 5 or 15Gy. Conclusion: In this group of patients, treatment with chemotherapy followed by intensity-modulated radiation therapy led to 29% developing LS; this symptom was independent of radiation dose and seemed to be an idiosyncratic reaction. This relatively high incidence could have resulted from prospective use of a structured interview.",

author = "Bassem Youssef and Shank, {Jo Ann} and Reddy, {Jay P.} and Pinnix, {Chelsea C.} and George Farha and Mani Akhtari and Allen, {Pamela K.} and Fanale, {Michelle A.} and Garcia, {John A.} and Horace, {Patricia H.} and Sarah Milgrom and Smith, {Grace Li} and Yago Nieto and Isadora Arzu and He Wang and Nathan Fowler and Rodriguez, {Maria Alma} and Bouthaina Dabaja",

note = "Publisher Copyright: {\textcopyright} 2015 Youssef et al.",

year = "2015",

month = sep,

day = "25",

doi = "10.1186/s13014-015-0504-7",

language = "English (US)",

volume = "10",

journal = "Radiation Oncology",

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T1 - Incidence and predictors of Lhermitte's sign among patients receiving mediastinal radiation for lymphoma

AU - Youssef, Bassem

AU - Shank, Jo Ann

AU - Reddy, Jay P.

AU - Pinnix, Chelsea C.

AU - Farha, George

AU - Akhtari, Mani

AU - Allen, Pamela K.

AU - Fanale, Michelle A.

AU - Garcia, John A.

AU - Horace, Patricia H.

AU - Milgrom, Sarah

AU - Smith, Grace Li

AU - Nieto, Yago

AU - Arzu, Isadora

AU - Wang, He

AU - Fowler, Nathan

AU - Rodriguez, Maria Alma

AU - Dabaja, Bouthaina

PY - 2015/9/25

Y1 - 2015/9/25

N2 - Purpose: To prospectively examine the risk of developing Lhermitte's sign (LS) in patients with lymphoma treated with modern-era chemotherapy followed by consolidation intensity-modulated radiation therapy. Methods: We prospectively interviewed all patients with lymphoma who received irradiation to the mediastinum from July 2011 through April 2014. We extracted patient, disease, and treatment-related variables from the medical records of those patients and dosimetric variables from treatment-planning systems and analyzed these factors to identify potential predictors of LS with Pearson chi-square tests. Results: During the study period 106 patients received mediastinal radiation for lymphoma, and 31 (29%) developed LS. No correlations were found between LS and any of the variables examined, including total radiation dose, maximum point dose to the spinal cord, volume receiving 105% of the dose, and volumes receiving 5 or 15Gy. Conclusion: In this group of patients, treatment with chemotherapy followed by intensity-modulated radiation therapy led to 29% developing LS; this symptom was independent of radiation dose and seemed to be an idiosyncratic reaction. This relatively high incidence could have resulted from prospective use of a structured interview.

AB - Purpose: To prospectively examine the risk of developing Lhermitte's sign (LS) in patients with lymphoma treated with modern-era chemotherapy followed by consolidation intensity-modulated radiation therapy. Methods: We prospectively interviewed all patients with lymphoma who received irradiation to the mediastinum from July 2011 through April 2014. We extracted patient, disease, and treatment-related variables from the medical records of those patients and dosimetric variables from treatment-planning systems and analyzed these factors to identify potential predictors of LS with Pearson chi-square tests. Results: During the study period 106 patients received mediastinal radiation for lymphoma, and 31 (29%) developed LS. No correlations were found between LS and any of the variables examined, including total radiation dose, maximum point dose to the spinal cord, volume receiving 105% of the dose, and volumes receiving 5 or 15Gy. Conclusion: In this group of patients, treatment with chemotherapy followed by intensity-modulated radiation therapy led to 29% developing LS; this symptom was independent of radiation dose and seemed to be an idiosyncratic reaction. This relatively high incidence could have resulted from prospective use of a structured interview.

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Incidence and predictors of Lhermitte's sign among patients receiving mediastinal radiation for lymphoma

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