Botulinum Toxin for Pain Relief in Cancer Patients: A Systematic Review of Randomized Controlled Trials
Lorenzo Lippi,
Alessandro de Sire,
Alessio Turco,
Martina Ferrillo,
Serdar Kesikburun,
Alessio Baricich,
Stefano Carda,
Marco Invernizzi
Affiliations
Lorenzo Lippi
Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
Alessandro de Sire
Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy
Alessio Turco
Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
Martina Ferrillo
Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
Serdar Kesikburun
Ankara Gaziler Physical Therapy and Rehabilitation Education and Research Hospital, Department of Physical Medicine and Rehabilitation, Gulhane Medical School, University of Health Sciences Turkey, 06800 Ankara, Turkey
Alessio Baricich
Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
Stefano Carda
Neuropsychology and Neurorehabilitation Service, Department of Clinical Neuroscience, Lausanne University Hospital, 1004 Lausanne, Switzerland
Marco Invernizzi
Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
Cancer pain is one of the most disabling symptoms complained by cancer patients, with a crucial impact on physical and psychological well-being. Botulinum neurotoxins (BoNTs) type A and B have emerged as potential interventions for chronic pain; however, their role in these patients is still debated. Thus, this systematic review of randomized controlled trials aimed at assessing the effects of BoNT treatment for cancer pain to guide physicians in an evidence-based approach integrating BoNT in cancer care. Out of 5824 records, 10 RCTs satisfied our eligibility criteria and were included in the present work for a total of 413 subjects with several cancer types (breast, head and neck, esophageal, and thoracic/gastric cancers). While some studies demonstrated significant pain reduction and improved quality of life post-BoNT-A injections, outcomes across different cancer types were inconclusive. Additionally, several effects were observed in functioning, dysphagia, salivary outcomes, esophageal strictures, gastric emptying, and expansions. This review emphasizes the need for further standardized research to conclusively establish the efficacy of BoNT in comprehensive cancer pain management.
