The Role of Botulinum Toxin Type A in the Radiation Fibrosis Syndrome: A Preliminary Report

• Published in: Archives of physical medicine and rehabilitation Vol. 89; no. 3; pp. 417 - 421
• Main Authors: Stubblefield, Michael D., MD, Levine, Aaron, MD, Custodio, Christian M., MD, Fitzpatrick, Theresa, PT
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-2008; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Botulinum Toxins, Type A - therapeutic use; Cancer; Cohort Studies; Diseases of striated muscles. Neuromuscular diseases; Dystonia; Female; Fibrosis - drug therapy; Fibrosis - etiology; Fibrosis, radiation; Follow-Up Studies; Humans; Injections, Intramuscular; Male; Medical sciences; Middle Aged; Muscle Spasticity - drug therapy; Muscle Spasticity - etiology; Neoplasms - pathology; Neoplasms - radiotherapy; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Pain; Pain Measurement; Physical Medicine and Rehabilitation; Radiation Injuries - diagnosis; Radiation Injuries - drug therapy; Radiotherapy Dosage; Rehabilitation; Retrospective Studies; Risk Assessment; Torticollis - drug therapy; Torticollis - etiology; Treatment Outcome; Trigeminal neuralgia; Trismus; Vascular diseases and vascular malformations of the nervous system; Trismus; Pain; Trigeminal neuralgia; Fibrosis, radiation; Dystonia; Rehabilitation; Cancer; Description; Prognosis; Metalloendopeptidases; Cardiovascular disease; Trigeminal Neuralgia; Involuntary movement; Masticatory muscle; Vascular disease; Cancer; Dystonia; Fibrosis; Bontoxilysin; Ionizing radiation; Reeducation; Trigeminal nerve; Complication; Neurological disorder; Cerebrovascular disease; Human; Nervous system diseases; Enzyme; Stomatology; Migraine; Thorax; Malignant tumor; Care; Cerebral disorder; Peptidases; Striated muscle disease; Treatment; Central nervous system disease; Fibrosis; Hydrolases; radiation; Pain; Rehabilitation; Trigeminal neuralgia; Trismus; Extrapyramidal syndrome
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2007.11.022

Abstract Stubblefield MD, Levine A, Custodio CM, Fitzpatrick T. The role of botulinum toxin type A in the radiation fibrosis syndrome: a preliminary report. 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.