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

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.