Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 3 , Pages 417-421, March 2008

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

  • Michael D. Stubblefield, MD

      Affiliations

    • Department of Neurology, Rehabilitation Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY
    • Corresponding Author InformationReprint requests to Michael D. Stubblefield, MD, Rehabilitation Medicine Service, Memorial Sloan-Kettering Cancer Center, Box 349, 1275 York Ave, New York City, NY 10021
    • ,
  • Aaron Levine, MD

      Affiliations

    • Department of Rehabilitation Medicine, New York-Presbyterian Hospital, New York, NY.
    • ,
  • Christian M. Custodio, MD

      Affiliations

    • Department of Neurology, Rehabilitation Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY
    • ,
  • Theresa Fitzpatrick, PT

      Affiliations

    • Department of Neurology, Rehabilitation Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY

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.

Key Words: Cancer, Dystonia, Fibrosis, radiation, Pain, Rehabilitation, Trigeminal neuralgia, Trismus

 

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(07)01815-1

doi:10.1016/j.apmr.2007.11.022

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 3 , Pages 417-421, March 2008

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