Albrecht H H, Creutzig H
Rofo. 1976 Dec;125(6):546-51. doi: 10.1055/s-0029-1230516.
Following high dose radio-iodine therapy, some radiation damage to the salivary glands is to be expected since iodine is taken up by these glands. The great individual variation in the uptake makes it impossible to predict the severity of the damage. T max and maximal excretion capacity after stimulation were therefore estimated by a camera functional scintigram with digital read out in patients following radioiodine therapy (0.1-3.2 Ci); the excretion index was used as an indirect measure of salivary flow. After a dose up to 0.3 Ci there is a change of T max and maximal excretion capacity in 30% of patients; after a dose of 0.5 to 1 Ci it is found in 60 and 80% and after very high doses of 1.1 to 3.2 Ci an abnormal Tmax was found in two-thirds of all patients and reduced or absent excretion capacity in all nine patients in this group. The excretion index also depended significantly on the cumulative dose. All patients who had received very high doses showed marked hyposialia or asialia. The early results of interim examinations suggest, similar to radio-iodine induced hypothyroidism, a cumulative risk of reduced function. In view of the long survival period of patients with differentiated thyroid carcinomas attention should be drawn to this side effect.
高剂量放射性碘治疗后,由于唾液腺会摄取碘,预计会对其造成一定程度的辐射损伤。碘摄取量存在很大的个体差异,因此无法预测损伤的严重程度。通过对接受放射性碘治疗(0.1 - 3.2居里)的患者进行带有数字读出功能的相机功能性闪烁扫描,来估计刺激后的Tmax和最大排泄能力;排泄指数被用作唾液流量的间接测量指标。剂量达到0.3居里后,30%的患者Tmax和最大排泄能力出现变化;剂量为0.5至1居里时,这一比例为60%和80%;剂量非常高,达到1.1至3.2居里时,三分之二的患者Tmax异常,该组9名患者全部出现排泄能力降低或丧失。排泄指数也显著依赖于累积剂量。所有接受高剂量治疗的患者均出现明显的唾液分泌减少或无唾液分泌。中期检查的早期结果表明,与放射性碘诱发的甲状腺功能减退症类似,存在功能降低的累积风险。鉴于分化型甲状腺癌患者的生存期较长,应关注这一副作用。