OBJECTIVES:Botulinum toxin type A (BtxA) has been reported to be feasible in chronic neuropathic pain after neck dissection. The impact of the dose on the outcome has not been investigated yet. STUDY DESIGN:Twenty-three patients with neuropathic pain after neck dissection were selected for an open and prospective phase II trial. METHODS: In the low-dose group (n=13), a concentration of 10 mouse units (MU)/0.1 mL saline and in the high-dose-group (n=10), a concentration of 20 MU/0.1 mL saline were injected subcutaneously. Pain and quality of life were assessed at day 0 and day 28, respectively, by visual analog scales (VAS) and European Organization for Research and Treatment of Cancer (EORTC) quality-of-life core and EORTC quality-of-life head and neck module questionnaires. RESULTS: Patients in the low-dose group showed a significant pain reduction (VAS) from 4.3 at day 0 to 3.0 at day 28 (P<.05). The mean painVAS values in the high-dose group did not improve significantly. No serious adverse events were observed. There were trends toward improvement in quality of life in the low-dose group. CONCLUSIONS: BtxA in a low concentration seems to be a useful therapeutic option in chronic neuropathic pain of the neck and shoulder after neck dissection.
RCT Entities:
OBJECTIVES: Botulinum toxin type A (BtxA) has been reported to be feasible in chronic neuropathic pain after neck dissection. The impact of the dose on the outcome has not been investigated yet. STUDY DESIGN: Twenty-three patients with neuropathic pain after neck dissection were selected for an open and prospective phase II trial. METHODS: In the low-dose group (n=13), a concentration of 10 mouse units (MU)/0.1 mL saline and in the high-dose-group (n=10), a concentration of 20 MU/0.1 mL saline were injected subcutaneously. Pain and quality of life were assessed at day 0 and day 28, respectively, by visual analog scales (VAS) and European Organization for Research and Treatment of Cancer (EORTC) quality-of-life core and EORTC quality-of-life head and neck module questionnaires. RESULTS:Patients in the low-dose group showed a significant pain reduction (VAS) from 4.3 at day 0 to 3.0 at day 28 (P<.05). The mean pain VAS values in the high-dose group did not improve significantly. No serious adverse events were observed. There were trends toward improvement in quality of life in the low-dose group. CONCLUSIONS: BtxA in a low concentration seems to be a useful therapeutic option in chronic neuropathic pain of the neck and shoulder after neck dissection.
Authors: Domenico Intiso; Mario Basciani; Andrea Santamato; Marta Intiso; Filomena Di Rienzo Journal: Toxins (Basel) Date: 2015-06-30 Impact factor: 4.546
Authors: Patrick B Trotter; Lindsey A Norton; Ann S Loo; Jonathan I Munn; Elena Voge; Kim W Ah-See; Tatiana V Macfarlane Journal: J Oral Maxillofac Res Date: 2013-01-01
Authors: V Wylde; J Dennis; A D Beswick; J Bruce; C Eccleston; N Howells; T J Peters; R Gooberman-Hill Journal: Br J Surg Date: 2017-07-06 Impact factor: 6.939