Abstract
Cancer patients who undergo surgery or radiation can develop persistent focal pain at the site of radiation or surgery. Twelve patients who had surgery or radiation for local cancer and failed at least two analgesic medications for pain control were prospectively enrolled in a research protocol. Patients were injected up to 100 units of incobotulinum toxin A (IncoA) intramuscularly or subcutaneously depending on the type and location of pain (muscle cramp or neuropathic pain). Two patients passed away, one dropped out due to a skin reaction and another patient could not return for the follow up due to his poor general condition. All remaining 8 subjects (Age 31–70, 4 female) demonstrated significant improvement of Visual Analog Scale (VAS) (3 to 9 degrees, average 3.9 degrees) and reported significant satisfaction in Patients’ Global Impression of Change scale (PGIC) (7 out of 8 reported the pain as much improved). Three of the 8 patients reported significant improvement of quality of life.
Highlights
Surgery and radiation for cancer treatment has focal side effects on skin, soft tissues, muscles and nerves leading to muscle atrophy, fibrosis and contracture [1,2,3]
We report the results of a pilot, prospective study, which assessed the efficacy and safety of incobotulinum toxin A in focal cancer pain of 8 subjects after cancer surgery or radiation
The level of pain was measured by the visual analog scale (VAS 0–10) and improvement of the quality of life (QOL) was assessed by the American Chronic Pain Association questionnaire
Summary
Surgery and radiation for cancer treatment has focal side effects on skin, soft tissues, muscles and nerves leading to muscle atrophy, fibrosis and contracture [1,2,3]. 30% of the patients with head and neck cancer and 20%–60% of the patients with breast cancer will have chronic pain localized to the site of radiation or surgery [4,5]. Treatment of post-surgical/post-radiation pain is difficult and failures are not uncommon. Local treatment for persistent pain with lidocaine patches and hyaluronic acid has provided only temporary relief [7,8]. Pain relief after local injection of onabotulinum toxin A (OnaA) and abobotulinum toxin A (AboA). Has been reported before in a small number of patients with post-radiation/post-surgical pain (Table 1). But not with incobotulinum toxin A (IncoA) In this communication, we report the results of a pilot, prospective study, which assessed the efficacy and safety of incobotulinum toxin A in focal cancer pain of 8 subjects after cancer surgery or radiation
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