Unilateral Diaphragmatic Weakness After Stereotactic Radiotherapy of The Lung: A Case Report

Abstract

Stereotactic body radiation therapy (SBRT) is the treatment of choice for patients with stage 1 non-small cell lung cancer (NSCLC) who are medically unfit or those refusing surgery. SBRT is a modality which is well tolerated with respect to limitations on surrounding organs and contra-indications. With improving techniques and cancer treatments, patients have a longer life span, but it is known that radiotherapy can cause late-onset complications. We are reporting the case of a 77-year-old woman who was treated with SBRT because of stage 1 NSCLC. She received a total dose of 51 Gy in three fractions, prescribed to the 78% isodose line. Eight months after SBRT she developed progressive dyspnea and the CT scan showed an elevated left hemi-diaphragm. Potential causes were ruled out. The SBRT treatment was performed without other complications. To our knowledge this complication has not previously been described after SBRT. With constant improving cancer treatments and radio-therapeutic techniques, and better longevity, we could see an increase in long term toxicity in the future.