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

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 26152655

The 2015 study above also showed equivalency in response to therapy with 10 Gy in 2 fractions and 20 ...

This is what our institution does. I utilized this a few months ago.

Kasarskis et al., PMID 21726879

Never done one but just saw this

Ati et al., Advances Rad Onc, 2023.

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 month...