Introduction: Radiation-induced plexopathy is a debilitating complication that can result from cancer treatment, leading to progressive motor and sensory deficits. This study aims to assess the outcomes of surgical intervention in patients with radiation-induced neuropathy who did not respond to conservative treatments.

Methods: A cohort of 161 female patients with confirmed radiation-induced plexopathy were referred for potential surgical management. Indications for surgery included progressive worsening of symptoms over 4-6 months despite conservative treatment, fibrosis detected on MRI or ultrasound, and plexopathy confirmed through electromyography (EMNG). Sixty-five patients underwent external neurolysis, with 52 cases treated via an infraclavicular approach and 13 through combined infraand supraclavicular procedures.

Results: Postoperative outcomes showed functional improvement, with most patients achieving motor recovery to an M3 level (active movement against gravity). However, symptoms persisted in many cases, with 43 of the 65 patients reporting weakness, 54 reporting pain, 9 experiencing lymphedema, and 40 showing reduced range of motion. Despite these residual symptoms, surgery contributed to a useful functional recovery in most patients.

Conclusion: Surgical intervention can lead to meaningful functional recovery in patients with radiation-induced plexopathy who have not improved with conservative treatment. While some symptoms such as pain and weakness may persist postoperatively, surgery plays an important role in managing the progression of this complex condition. Further research is needed to optimize treatment strategies and long-term outcomes.