title: Managing excessive saliva with salivary gland irradiation in patients with amyotrophic lateral sclerosis.
abstract: OBJECTIVE
  A significant fraction of patients with amyotrophic lateral sclerosis (ALS) are unable to swallow saliva, which may result in the spillage of saliva outside of the oral cavity. Although anticholinergic agents and botulin toxin injections are considered the first line of treatment, they have not been effective for all patients. We performed a literature search on therapeutic salivary gland irradiation in patients with ALS.
  
  
  METHODS
  We searched the PubMed for English language publications up to December 2014 on therapeutic salivary gland irradiation in patients with ALS. The search was performed using the following key words: amyotrophic lateral sclerosis, excessive salivation, sialorrhea, and radiation therapy.
  
  
  RESULTS
  The majority of ALS patients with excessive salivation respond well to salivary gland irradiation. The whole bilateral submandibular, and whole or partial bilateral parotid glands have been the target tissue for radiation therapy in most of the published studies. Various radiation therapy regimens have been utilized. The response to radiation therapy lasts for several months.
  
  
  CONCLUSIONS
  The majority of ALS patients with excessive salivation respond well to salivary gland irradiation. Neurologists should consider this treatment option for select patients with ALS and excessive salivation.
authors.affiliation: Department of Radiation Oncology at Carle Cancer Center, University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Slade
authors.affiliation: Department of Radiation Oncology at Carle Cancer Center, University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL, USA. Electronic address: sinisa.stanic@carle.com.
authors.forename: Sinisa
authors.initials: S
authors.lastname: Stanic
mesh_terms: D000328:Adult; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000503:physiopathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000528:radiation effects; D012469:Salivary Glands / Q000528:radiation effects*; D012472:Salivation / Q000528:radiation effects*; D012798:Sialorrhea / Q000209:etiology / Q000532:radiotherapy*; D016896:Treatment Outcome
keywords: Amyotrophic lateral sclerosis; Excessive salivation; Radiation therapy; Salivary glands; Sialorrhea; Symptom management