Measuring health-related quality of life after sialendoscopy intervention in patients after prostate-specific membrane antigene targeting alpha-therapy (PSMA-TAT)

Introduction:

Main side effect of prostate-specific membrane antigene targeting alpha-therapy (PSMA-TAT) is the dry-mouth-syndrome. Sialendoscopy with dilatation, saline irrigation and steroid injections (prednisolone) were performed before or after 225Ac-PSMA-617-TAT to reduce inflammation effects in the salivary glands and improve or prevent xerostomia.

Methods:

Eleven male patients with metastatic castration-resistant prostate cancer (mCRPC) and a mean age of 68.5 years (range 58 – 80 y) underwent sialendoscopy, dilatation, saline irrigation and steroid injection of both submandibular and both parotid glands before or after application of 225Ac-PSMA-617-TAT for every cycle. Quality of life assessment was evaluated using two health-related quality of life (HRQOL) questionnaires, the Xerostomia Questionnaire (XQ) and the Xerostomia Inventory (XI) pre- and three months postoperatively.

Results:

In all 11 patients both parotid- and both submandibular glands were affected due to radiation sialadenitis and sialendoscopic intervention applied. Patients treated with sialendoscopy showed a significant improvement in HRQOL measurements regarding the XQ and XI. After sialendoscopy the XQ score decreased significantly from 77.7 ± 13.6 to 42.7 ± 14.8 (p = 0.003) and the XI score decreased from 44.5 ± 6.9 to 25.8 ± 12.8 (p = 0003).

Conclusions:

Sialendoscopy with dilatation, saline irrigation and steroid injection had beneficial effects to the salivation function and health-related quality of life for patients under 225Ac-PSMA-617-RLT. However, even with sialadenoscopic support after multiple cycles of TAT, salivary gland function was reduced and xerostomia was present.

Publication History

Publication Date:
23 April 2019 (online)