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

Abstract

BackgroundTo determine the safety of Botox and its potential effect on alleviating radiation therapy (RT)‐induced sialadenitis in head and neck cancer patients.MethodsTwenty 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.ResultsNo 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.ConclusionBotox 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.

Botulinum Toxin for Pain Relief in Cancer Patients: A Systematic Review of Randomized Controlled Trials

“…Of these, 34 articles were excluded due to inconsistency with eligibility criteria, and Supplementary Table S2 provides a detailed list of excluded studies along with the reasons for their exclusion. Lastly, 10 studies [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] were included in the qualitative synthesis. Further insights into the search process can be found in the PRISMA flow diagram shown in Figure 1 .…”

“…The studies included in this systematic review were published between 2006 [ 34 ] and 2023 [ 31 ]. Three studies were conducted in the USA [ 29 , 30 , 31 ], two studies were conducted in Belgium [ 27 , 28 ], two studies were conducted in Germany [ 32 , 34 ], one study was conducted in Iran [ 26 ], while the remaining two studies were carried out in China [ 33 , 35 ]. The sample size of the RCTs included ranged from 12 [ 32 ] to 78 [ 35 ], for a total of 413 subjects included in the systematic review.…”

“…The mean age of the subjects included ranged from 44.5 (range 27–64) years [ 29 ] to 66.3 ± 10.2 years [ 31 ].…”

“…The sample of the present study was composed of 153 patients with breast cancer [ 27 , 28 , 29 , 30 ], 55 patients with head and neck cancer [ 31 , 32 , 34 ], 145 patients with esophageal cancer [ 33 , 35 ], and 60 with thoracic and gastric esophageal cancer [ 26 ].…”

“…In all the studies (100%), the intervention was characterized by BoNT-A injections [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] and compared to different types of treatment. In particular, the control groups were treated with placebo infiltrations [ 27 , 28 , 29 , 30 , 31 ], a combination of BoNT-A and BoNT-B [ 32 ], high-dose of BoNT [ 34 ], triamcinolone acetonide [ 35 ], and only surgery procedures [ 26 , 33 , 35 ]. The characteristics of these studies are presented in detail in Table 1 .…”