Huang Rui, Yu Haifang, Kuang Anren
Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2002 Dec;19(4):708-11.
Differentiated thyroid cancer can be effectively treated with high-dose 131I and the other head and neck cancer can also be effectively treated with extra-radiotherapy, but these treatments often result in a reduction in salivary gland function, causing xerostomia. Collectively, these effects can lead to severe secondary complications, including difficulty in speaking and swallowing, decreasing appetite even affecting nutrition and sleep. Amifostine, an analog of cysteamine, is a phosphorlyated aminothiol prodrug and its active metabolite, WR-1065 etc, can selectively protect normal tissues from the cytotoxic effects of drugs and/or radiation while preserve antitumor effects. Many studies have demonstrated that amifostine protects normal tissues from both acute and late extra-radiation damage without protecting the tumor. It has been approved by FDA to be used for protecting the salivary gland from xerostomia caused by radiotherapy. It has also show protecting effects on intra-radiotherapy, but there are many problems waiting for study.
分化型甲状腺癌可以用大剂量131I有效治疗,其他头颈癌也可以用外照射放疗有效治疗,但这些治疗常常导致唾液腺功能减退,引起口干症。总的来说,这些影响可导致严重的继发性并发症,包括说话和吞咽困难、食欲下降,甚至影响营养和睡眠。氨磷汀,一种半胱胺类似物,是一种磷酸化氨基硫醇前药,其活性代谢产物WR-1065等可选择性保护正常组织免受药物和/或辐射的细胞毒性作用,同时保留抗肿瘤作用。许多研究表明,氨磷汀可保护正常组织免受急性和晚期外照射损伤,而不保护肿瘤。它已被美国食品药品监督管理局批准用于保护唾液腺免受放疗引起的口干症。它也显示出对内照射放疗的保护作用,但有许多问题有待研究。