Botox for the prevention of radiation‐induced Sialadenitis and xerostomia in head and neck cancer patients: A pilot study

Background To determine the safety of Botox and its potential effect on alleviating radiation therapy (RT)‐induced sialadenitis in head and neck cancer patients. Methods Twenty patients with stage III/IV head and neck cancer were randomized to receive Botox or saline injections into both submandibul...

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Bibliographic Details
Published in:Head & neck 2023-09, Vol.45 (9), p.2198-2206
Main Authors: Nieri, Chad Alexander, Benaim, Ezer Haim, Zhang, Yanhui H., Garcia‐Godoy, Franklin, Herr, Michael J., Zhang, Weiqiang, Schwartz, David, Coca, Kimberly K., Gleysteen, John P., Gillespie, Marion Boyd
Format: Article
Language:English
Subjects:
Botox
botulinum neurotoxin‐A
Botulinum toxin
Cancer therapies
Chemotherapy
Head & neck cancer
head and neck cancer
Inflammation
inflammatory cytokines
Leukocytes (neutrophilic)
Radiation
Radiation therapy
radiation‐induced
Saliva
salivary flow
Salivary gland
Sialadenitis
Xerostomia
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Summary:Background To determine the safety of Botox and its potential effect on alleviating radiation therapy (RT)‐induced sialadenitis in head and neck cancer patients. Methods Twenty patients with stage III/IV head and neck cancer were randomized to receive Botox or saline injections into both submandibular glands (SMG). There were three visits: one before RT (V1); 1 week after RT (V2); and 6 weeks after RT (V3), each of which included saliva collection, a 24‐h dietary recall, and a quality‐of‐life survey. Results No adverse events were observed. While the control group was much older, the Botox group more commonly underwent induction chemotherapy compared with controls. From V1 to V2, salivary flow decreased in both groups, but only in the control group from V1 to V3. CXCL‐1 (GRO), a neutrophil chemoattractant, was lower in the Botox group compared with the control group at V3. Conclusion Botox can be safely administered to the salivary glands prior to external beam radiation without observed complications or side‐effects. After an initial reduction in salivary flow following RT, the Botox group showed lack of further flow reduction compared with controls. The inflammatory marker CXCL 1, which was reduced in the in Botox group at V3, may be a candidate for further studies of radiation‐induced sialadenitis.
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.27449