Science and Research

Safety and Efficacy of Botulinum Toxin to Preserve Gland Function after Radiotherapy in Patients with Head and Neck Cancer: A Prospective, Randomized, Placebo-Controlled, Double-Blinded Phase I Clinical Trial

This prospective, randomized, placebo-controlled, double-blinded phase I clinical trial investigates safety and efficacy of botulinum toxin (BoNT) to preserve gland function after radiotherapy in patients with head and neck cancer. Twelve patients with advanced head and neck cancer were injected with BoNT into the submandibular glands prior to primary radiochemotherapy. Six patients received BoNT/A and 6 patients BoNT/A and B, half of each subgroup into their left and the other half into their right gland. As an internal control, sodium chloride was injected into the respective contralateral gland (placebo). For the evaluation of the salivary gland function, technetium pertechnetate salivary gland scintigraphy was performed before and after the end of radiotherapy. BoNT/A and B were well tolerated. Analysis of the scintigraphic data revealed no statistically significant difference between BoNT and placebo regarding the scintigraphic uptake difference (pBoNT/A = 0.84 and pBoNT/A-B = 0.56 for BoNT/A vs. placebo and BoNT/A-B vs. placebo, respectively). We also found no significant difference in treatment between BoNT and placebo in terms of salivary excretion fraction (pBoNT/A = 0.44; pBoNT/A-B = 0.44). This study demonstrates that BoNT can be safely combined with radiochemotherapy. Dosing and timing of BoNT injection should be further investigated for efficacy analysis. Trial Registration German Registry for Clinical Trails DRKS00004595.

  • Teymoortash, A.; Pfestroff, A.; Wittig, A.; Franke, N.; Hoch, S.; Harnisch, S.; Schade-Brittinger, C.; Hoeffken, H.; Engenhart-Cabillic, R.; Brugger, M.; Strauch, K.

Keywords

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Botulinum Toxins, Type A/administration & dosage/adverse effects/*therapeutic use
  • Carcinoma, Squamous Cell/drug therapy/*radiotherapy
  • Chemoradiotherapy/adverse effects
  • Double-Blind Method
  • Female
  • Head and Neck Neoplasms/drug therapy/*radiotherapy
  • Humans
  • Male
  • Middle Aged
  • Radionuclide Imaging/methods
  • Radiotherapy/*adverse effects
  • Salivary Glands/*drug effects/physiology/radiation effects
  • Treatment Outcome
Publication details
DOI: 10.1371/journal.pone.0151316
Journal: PloS one
Pages: e0151316 
Number: 3
Work Type: Original
Location: UGMLC
Disease Area: LC
Partner / Member: UMR
Access-Number: 26991494
See publication on PubMed

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