Kosuda S, Satoh M, Yamamoto F, Uematsu M, Kusano S
Department of Radiology, National Defense Medical College, Tokorozawa, Japan.
Int J Radiat Oncol Biol Phys. 1999 Sep 1;45(2):379-84. doi: 10.1016/s0360-3016(99)00166-2.
To assess chemoradiotherapy-induced salivary gland dysfunction using quantitative salivary gland scintigraphy (QSGS), and whether QSGS is capable of predicting the grade of persistent salivary dysfunction after chemoradiotherapy.
From a time-activity curve using a stimulation test, the washout rate (WR) calculated was assessed. All glands (n = 155) were classified into four groups: a no-therapy group (n = 18), a chemotherapy alone group (n = 31), a radiotherapy alone group (n = 50), and a chemoradiotherapy group (n = 56). Subjective descriptions of xerostomia were recorded 1 year after the completion of the treatment period, and the 32 glands subjected to irradiation with or without chemotherapy were assessed.
The WR values were significantly lower in glands that received chemoradiotherapy than in glands treated with radiotherapy alone (mean: 0.75 x 10(-3), n = 40 vs. 0.22, n = 36, p < 0.015), but there was no significant difference in the WR values between the no-therapy group and the chemotherapy alone group. The mean values of WR were lower in the chemoradiotherapy glands than in the radiotherapy alone glands in each of cumulative dose ranges of 1-20, 21-30, and 31-60 Gy. With regard to recovery from xerostomia, the WR values at a cumulative dose range of 20 to 40 Gy were significantly lower in the not improved group (-0.418, n = 16) than in the improved group (0.245, n = 16) (p < 0.0001).
Chemotherapy per se has no or little adverse effect on salivary function, but combination chemotherapy can deteriorate radiation-induced injury of the salivary glands. QSGS appears useful in predicting the grade of persistent xerostomia following chemoradiotherapy.
使用定量唾液腺闪烁扫描法（QSGS）评估放化疗引起的唾液腺功能障碍，以及QSGS是否能够预测放化疗后持续性唾液功能障碍的分级。
根据刺激试验的时间-活性曲线，评估计算出的洗脱率（WR）。所有腺体（n = 155）分为四组：未治疗组（n = 18）、单纯化疗组（n = 31）、单纯放疗组（n = 50）和放化疗组（n = 56）。在治疗期结束1年后记录口干的主观描述，并对32个接受或未接受化疗照射的腺体进行评估。
接受放化疗的腺体的WR值显著低于单纯接受放疗的腺体（平均值：0.75×10⁻³，n = 40对0.22，n = 36，p < 0.015），但未治疗组和单纯化疗组的WR值无显著差异。在1 - 20、21 - 30和31 - 60 Gy的每个累积剂量范围内，放化疗腺体的WR平均值均低于单纯放疗腺体。关于口干的恢复情况，未改善组（-0.418，n = 16）在20至40 Gy累积剂量范围内的WR值显著低于改善组（0.245，n = 16）（p < 0.0001）。
化疗本身对唾液功能无或几乎无不良影响，但联合化疗会使辐射诱导的唾液腺损伤恶化。QSGS似乎有助于预测放化疗后持续性口干的分级。
