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Unilateral parotid electron beam radiotherapy as palliative treatment for sialorrhea in amyotrophic lateral sclerosis.

Abstract
When ALS patients experience oropharyngeal weakness, sialorrhea can become a considerable challenge. Drooling has a profound negative impact in patient's quality of life causing embarrassing social situations. Several therapeutic modalities, including anticholinergic drugs, botulinum toxin injection, and radiotherapy have emerged as treatments for drooling in ALS. This retrospective case series study examined the effect of palliative radiotherapy in controlling problematic oral secretions in 10 ALS patients refractory to medical management. External electron beam radiation was targeted to a single parotid gland unilaterally with a total dose of 1500 cGy in 3 fractions at a depth determined by CT scanning. One patient received additional radiotherapy to the contralateral parotid due to persistent secretions. All patients reported improvement with a reduction in the intensity and amount of drooling. In 5 of 10 patients, anticholinergics were discontinued and were reduced in another two. There were no major side effects of treatment. We conclude that unilateral parotid electron radiotherapy provides satisfactory relief from sialorrhea in ALS patients and should be considered as a therapeutic option for patients who are refractory to medical management.
AuthorsEdward J Kasarskis, Jacob Hodskins, William H St Clair
JournalJournal of the neurological sciences (J Neurol Sci) Vol. 308 Issue 1-2 Pg. 155-7 (Sep 15 2011) ISSN: 1878-5883 [Electronic] Netherlands
PMID21726879 (Publication Type: Comparative Study, Journal Article)
CopyrightCopyright © 2011 Elsevier B.V. All rights reserved.
Topics
  • Aged
  • Aged, 80 and over
  • Amyotrophic Lateral Sclerosis (complications, diagnostic imaging, radiotherapy)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Palliative Care (methods)
  • Parotid Gland (diagnostic imaging, radiation effects)
  • Particle Accelerators (instrumentation)
  • Radiography
  • Sialorrhea (diagnostic imaging, etiology, radiotherapy)

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