The role of botulinum toxin type A in the radiation fibrosis syndrome: a preliminary report

Arch Phys Med Rehabil. 2008 Mar;89(3):417-21. doi: 10.1016/j.apmr.2007.11.022.

Abstract

Objective: To describe the use of botulinum toxin type A (BTX-A) in radiation fibrosis syndrome (RFS).

Design: Retrospective case series.

Setting: A large tertiary care cancer center.

Participants: Twenty-three consecutive patients treated for sequelae of RFS with BTX-A.

Interventions: Not applicable.

Main outcome measures: A description of the components of RFS thought to benefit from BTX-A injections and the patient's self-report of benefit from those injections.

Results: The sequelae of RFS for which BTX-A injection was thought to be indicated include radiation-induced cervical dystonia in 18 (78%), trigeminal nerve or cervical plexus neuralgia in 10 (43%), trismus in 7 (30%), migraine in 3 (13%), and thoracic pain in 1 (4%) patient. Most (87%) patients self-reported benefit from the injections.

Conclusions: Initial clinical experience with the use of BTX-A as adjunctive treatment for select neuromuscular and musculoskeletal complications of RFS in a variety of cancer patients has been encouraging. Well-designed prospective studies are needed to clarify the potential beneficial role of BTX-A in specific sequelae of RFS.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Botulinum Toxins, Type A / therapeutic use*
  • Cohort Studies
  • Female
  • Fibrosis / drug therapy*
  • Fibrosis / etiology
  • Follow-Up Studies
  • Humans
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Muscle Spasticity / drug therapy
  • Muscle Spasticity / etiology
  • Neoplasms / pathology
  • Neoplasms / radiotherapy*
  • Pain Measurement
  • Radiation Injuries / diagnosis
  • Radiation Injuries / drug therapy*
  • Radiotherapy Dosage
  • Retrospective Studies
  • Risk Assessment
  • Torticollis / drug therapy*
  • Torticollis / etiology
  • Treatment Outcome

Substances

  • Botulinum Toxins, Type A