Table 1.
Published studies on the effect of botulinum neurotoxins (BoNT) on local pain resulting from radiation and/or surgery *.
| Authors | Pts Study | Toxin | Dose Units | Treatment | Location of Cancer | Primary Outcome | Result |
|---|---|---|---|---|---|---|---|
| Van Daele et al., 2002 [12] | 6 Retro |
OnaA | 20–25 | Radiation chemotherapy | Head and neck | Pain VAS | Complete pain relief in four of six patients. Significant improvement of quality of life using SF36, EQ-5D scales |
| Layeeque et al., 2004 [13] | 48 Pro |
OnaA | 100 | Mastectomy, assessed for pain after expander placement | Breast | (1) Pain assessed by VAS (2) Narcotic use |
Less pain in BoNT group (p < 0.00001) Less narcotic use in BoNT group (p < 0.0001) |
| Vasan et al., 2004 [14] | 16 Pro |
AboA | 100 to 320 | Surgery | Head and neck | Pain (VAS- days 3 and 4 weeks), global. Quality of life |
Significant pain reduction (p = 0.05); Quality of life improved (p = 0.7) |
| Wittekindt et al., 2006 [15] | 23 Pro |
OnaA | 60–120 160–240 |
Radiation; surgery |
Head and neck | Pain VAS: 28 weeks |
Significant reduction of pain (<0.05) |
| Hartl et al., 2008 [16] | 19 Pro |
OnaA AboA |
50 250 |
Chemotherapy; radiation |
Head and neck | Pain: (VAS) Function: At 4 weeks |
Improved pain (p = 0.02) Function (p = 0.04) |
| Stubblefield et al., 2008 [17] | 23 Retro |
OnaA | 25–200 | Radiation; surgery |
Head, neck, breast | Pain (VAS) | Pain improved in Improved in 85% of patients |
| Mittal et al., 2012 [18] | 7 Retro |
OnaA | 100 | Radiation; surgery |
Head, neck, breast | Pain (VAS) PGIC At 4 weeks |
VAS: Six of seven patients improved: p < 0.05 PGIC: Six of seven, very satisfied QoL: Six of seven improved (p < 0.05) |
| Bach et al., 2012 [19] | 9 Pro |
OnaA | 100–400 | Radiation and surgery |
Head and neck | Pain (VAS) and FDSNP at 4 weeks | Both pain and FDSNP improved (p < 0.01) |
| Rostami et al., 2014 [20] | 12 Pro |
IncoA | 100 | Radiation and surgery |
Head neck breast | Pain (VAS) and PGIC at week 6 | VAS improved (p < 0.05) PGIC: Very satisfied QoL improved in 38% of patients (p < 0.05) |
| De Groef et al. 2018 [21] | 50 DBPC |
onaA | 100 | Surgery | Breast | Pain measured by VAS | Pain reduction 60% in the BoNT and 40% in saline group (statistically ns) |
| Mailly et al., 2019 [22] | 16 Retro |
incoA aboA |
20 40 |
Radiation and surgery | Head and neck | Pain (VAS) | VAS improved p < 0.01 |
* Case reports are not included. onaA: OnabotulinumtoxinA; aboA: AbobotulinumtoxinA; incoA: IncobotulinumtoxinA; VAS: Visual Analogue Scale; PGIC: Patient Global Impression of Change; FDSNP: Functional Disability Scale for Neck Pain; Pro: Prospective; Retro: Retrospective; DBPC: double-blind, placebo-controlled; QoL: Quality of Life.