Botulinum toxin in the treatment of post-radiosurgical neck contracture in head and neck cancer: A novel approach - 08/03/12
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Summary |
Neck pain affects a third of patients following head-and-neck cancer treatment, whether by radiation therapy or surgery. It is a disabling condition and the associated muscle contractures impair cervical motion. Type-A botulinum toxin is an analgesic and muscle relaxant, able to improve patients’ quality of life. We here report our experience with botulinum toxin in post-radiosurgical neck contracture.
Patients and methods |
A single-center pilot study was run from January 2007 to July 2008, respecting the Declaration of Helsinki. All patients in complete remission from head-and-neck cancer with post-radiosurgical neck contracture impairing neck motion were included. Pain and functional impairment were assessed on a neck-function disability scale before and 1 month after botulinum toxin injection. Efficacy duration was measured. Complications at the injection site or related to drug diffusion were investigated.
Results |
Nine consecutive patients (six male, three female; mean age, 61 years [range, 52–73 years]) were included. In six patients, the sternocleidomastoid muscle was injected and the muscular pedicle of a pectoralis major flap in three. Mean cervical disability score fell significantly from 33 to 23 (P=0.01). There were no complications. Efficacy was seen at a mean 6 days, and analgesia and muscle relaxation lasted for a mean 19 days.
Conclusion |
In post-radiosurgical neck contracture, botulinum toxin injection is a simple and easy procedure able to improve neck motion and reduce neck pain in head-and-neck cancer patients. A phase-II prospective study to determine injection sites and dosage should help bear out these preliminary findings.
Le texte complet de cet article est disponible en PDF.Keywords : Fibrosis, Radiation therapy, Pain, Cervical dystonia, Cancer sequelae
Plan
Vol 129 - N° 1
P. 6-10 - février 2012 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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