image:
Figure 1. Protecting salivary glands with toxin and scollamin during successive treatment with the target of PSMA.
Pre -treatment 68The GA-PSMA PET/CT showed comparable tracker intake both in parody and in subordinate glands. The patient then received toxin with ultrasound guidance (170 units in the parotid gland and 80 points in the slim -sided sub -gland) 30 days before successive radio frequency therapy, along with 3 mg of transdermal stenteal stencholine. The SPECT/CT images after the injection revealed a strong decrease in the PSMA radio frequency intake in the BTX -treated glands, with a ratio of parodiac glands shifting from 0.93 to 1.15 and a proportion of subordinate glands from 1.39 to 2.14, confirming the targeted protection. The patient climbed both the intervention and the next PRLT (6.2 GBQ 177Lu-psma and 5 MBQ 225AC-PSMA) Without Xerostomia or other important side effects.
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Credit: Pictures created by Tianzhi Zhao, Jingjing Zhang, et al., Singapore National University, Singapore / Richard P. Baum et al.
New Orleans-A double protection approach using Botulinum (botox) toxin (Botox) along with a patch of anti-neausea significantly reduces salivary gland toxicity in patients with metastatic prostate cancer undergoing radiopharmaceutical therapy targeting PSMA. The strategy has led to a 30 % reduction in PSMA intake by salivary glands without affecting the effectiveness of the fight against treatment cancer. This reduction can enhance treatment adhesion and improve the overall results of patients. The findings were presented at the Nuclear Medicine and Molecular Imaging Company 2025 Annual Meeting.
The salivary gland toxicity from radiopharmaceutical therapy-in particular from alpha-emitting treatments such as 225AC-PSMA-is a critical dose-limit side effect, which often leads to debilitating dry mouth. Previous efforts to relieve dry mouth using cold packages, individual anticholinergically or external cooling have shown little protective benefit.
“In order for patients to maintain a good quality of life and continue with their treatments, it is necessary to address these serious drying issues in the mouth,” said Tianzhi Zhao, a research research assistant at the Center of Theranostics in Yong Loo Lin at the Medical School. “Our study investigated the use of botox in combination with a nausea patch to reduce the recruitment of radiation in salivary glands.”
Fourteen patients participated in the study and received Botox injections into the parotids and subomanic glands on the opposite sides of the body three to four weeks before their combination 225Ac- and 177Lu-PSMA Radiopharmaceutical Therapy. Three days before treatment, nausea were applied behind the ears where they remained up to two hours after treatment. Molecular imaging was carried out before and after treatment to measure the intake of the salivary gland.
There was a significant decrease in the recruitment of PSMA radio frequency in salivary glands. Botox -filled parotid glands showed an average reduction of 30 % in PSMA intake compared to the opposite parotid gland. An average decrease of 17 % of PSMA intake was observed in injectable subcontinental glands compared to the opposite hypomanic glands. Injections were well tolerated, with patients reporting mild infusion pain, but without serious or systemic side effects. No patient interrupted PSMA treatment due to dry mouth.
“This study shows that Botox, administered in recommended doses in combination with a nausea patch, offers a very promising therapeutic strategy to reduce Salivary Gland Toxicy’s induced radiation without compromising PSMA volume,” said Jingj Center of Extrehence at the Yong Lin Lin of the National University at the National University of the National University. “The importance of this project lies in the immediate benefit of the patient and to his potential to extend the therapeutic utility of PSMA radio therapy. 225Ac. ”
Both Botox and wreckage are approved by FDA drugs, which are already available in clinical practice for other indications. As this approach utilizes approved drugs with established safety profiles, this strategy could be immediately applied to experienced centers that provide treatment with radioactive PSMA.
Summary 251452. 225Ac- and 177Radiofrequency therapy (Tandem PSMA-RLT), Tianzhi Zhao and Jingjing Zhang, Singapore National University, Joerg Mueller, Vivantes Klinikum Spandau, Xin Fan, Nanjing Drum Tower Hospital Wiesbaden-Frankfart.
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All annual meeting summaries 2025 SNMMI can be found online.
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Title
Botulinum Plus Scopalamine toxin as a protective strategy against salivary gland toxicity in patients treated with 225ac radio frequency treatment (Tandem PSMA-RLT)
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