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. 2018 Feb;52(1):80-81.
doi: 10.1007/s13139-017-0508-3. Epub 2018 Jan 11.

Injection of Botulinum Toxin for Preventing Salivary Gland Toxicity after PSMA Radioligand Therapy: an Empirical Proof of a Promising Concept

Richard P Baum  1 , Thomas Langbein  1 , Aviral Singh  1 , Mostafa Shahinfar  1 , Christiane Schuchardt  1 , Gerd Fabian Volk  2 , Harshad Kulkarni  1
Affiliations

Injection of Botulinum Toxin for Preventing Salivary Gland Toxicity after PSMA Radioligand Therapy: an Empirical Proof of a Promising Concept

Richard P Baum et al. Nucl Med Mol Imaging. 2018 Feb.

Abstract

The dose-limiting salivary gland toxicity of 225Ac-labelled PSMA for treatment of metastatic, castration-resistant prostate cancer remains unresolved. Suppressing the metabolism of the gland by intraparenchymal injections of botulinum toxin appears to be a promising method to reduce off-target uptake. A 68Ga-PSMA PET/CT scan performed 45 days after injection of 80 units of botulinum toxin A into the right parotid gland in a 63-year-old patient showed a decrease in the SUVmean in the right parotid gland of up to 64% as compared with baseline. This approach could be a significant breakthrough for radioprotection of the salivary glands during PSMA radioligand therapy.

Keywords: Botulinum toxin; PSMA radioligands; Positron emission tomography; Prostate cancer; Salivary glands; Xerostomia.

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Conflict of interest statement

Compliance with Ethical StandardsRichard P. Baum, Thomas Langbein, Aviral Singh, Mostafa Shahinfar, Christiane Schuchardt, Gerd Fabian Volk, Harshad Kulkarni declare that they have no conflict of interest.All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the1964 Declaration of Helsinki and its later amendments or comparable ethical standards.Informed consent was obtained from the patient who was the subject of the study.

Figures

Fig. 1
Fig. 1
Axial fused (a, c) and sagittal reconstructed 3D (b, d) 68Ga-PSMA PET/CT images in a 63-year-old patient with advanced metastatic castration-resistant prostate cancer before (a, b) and 45 days after (c, d) multifocal, ultrasound-guided injections of a total of 80 units botulinum toxin A into the right parotid gland. The SUVmean of the radioligand in the injected parotid gland shows a highly significant decrease of up to 60% compared with the left side (c, d white arrows), especially in the pars profunda of the gland, and a decrease of up to 64%, but no significant change in the left parotid gland, compared with the baseline PET/CT study (a, b)
See this image and copyright information in PMC

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