When treating sialorrhea in ALS patients, what treatment schedule do you use?

Topics: Head and Neck Cancers • Radiation Oncology • Non-malignant Disease • Neurology • Neuromuscular

Assouline et al., PMID 24411632 recommend delivering 500cGy x 4 fractions = 2000cGy on days 1, 3, 8, 10. Do you follow this schedule, treat every other day, or daily?

Answer from: Radiation Oncologist at Academic Institution

I have treated one patient. We used 12 Gy in 3 fractions, delivered twice weekly. The dose was based on a systematic review that did not show a dose response above 12 Gy. Hawkey et al., PMID 26152655The 2015 study above also showed equivalency in response to therapy with 10 Gy in 2 fractions an...

Comments

at UPMC
As a first step or after a trial of anticholinergi...

Radiation Oncologist at CarolinaEast Radiation Oncology
After failed medical management, in this particula...

Radiation Oncologist at Confluence Health
Just finished treating two patients with sialorrhe...

Answer from: Radiation Oncologist at Community Practice

This is what our institution does. I utilized this a few months ago. Kasarskis et al., PMID 21726879

Answer from: Radiation Oncologist at Community Practice

Never done one but just saw this Ati et al., Advances Rad Onc, 2023.

Answer from: Radiation Oncologist at Community Practice

We treated these regularly (1-2 patients per month) in residency at University of Cincinnati with close input from Neurology after failed medical management. I honestly don’t know if they still treat these patients regularly. We would treat one parotid 15 Gy/3 Fx, and evaluate response after a...

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