Unilateral Diaphragmatic Paralysis After Stereotactic Ablative Radiation Therapy to a Lung Tumor Abutting the Course of the Phrenic Nerve

We present the case of a woman with metastatic adenoid cystic carcinoma who received stereotactic ablative radiation therapy with a total dose of 50 Gy in 4 fractions to 2 lung metastases and developed symptomatic left phrenic nerve injury 2 years after radiation. The maximum dose to the approximate location of the phrenic nerve was 57.7 Gy, which corresponds to a biologically effective dose for late effects (using a/b ratio = 3) of 335.14 Gy. Here, we discuss the case, planning considerations by radiation oncologists and medical physicists, and the multidisciplinary medical management of this patient.(c) 2023 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Automated summary

This article presents a case of a woman with metastatic adenoid cystic carcinoma who developed symptomatic left phrenic nerve injury 2 years after receiving stereotactic ablative radiation therapy. The article discusses the planning considerations by radiation oncologists and medical physicists, as well as the multidisciplinary medical management of the patient.