Esfahani Armaghan Fard, Fallahi Babak, Olamaie Reza, Eftekhari Mohammad, Beiki Davood, Saghari Mohssen
Research Institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Iran.
Hell J Nucl Med. 2004 Sep-Dec;7(3):206-9.
Sialadenitis and xerostomia are well-known side effects of high-dose radioactive iodine ((131)Iota) treatment in patients with differentiated thyroid carcinoma (DTC). This study was undertaken to determine salivary gland function semi-quantitatively in patients with DTC given (131)I for the treatment of the thyroid remnant and/or metastases. Thirty-six patients, 11 males and 25 females, mean age 53.5 years, range 22-73 years, were studied. Scintigraphy of the salivary glands was performed with (99m)Tc-pertechnetate and the salivary excretion fraction (SEF) of the parotid and the submandibular glands was calculated as a measure of their function. Measurements were performed before (131)I treatment as a baseline study, and three weeks and three months later. The patients were clinically evaluated by a standardized subjective questionnaire. Results were as follows: Mean SEF at three weeks and three months after (131)I treatment was reduced as compared to baseline measurements. The total mean baseline measurements, those of three weeks and those of three months later were: 54.9%, 47.2% and 46% respectively; P<0.05 for both measurements (Table 1). The SEF decrease of the parotid glands was greater than that of the submandibular glands (P<0.05 as compared for both salivary glands before and three weeks and three months after (131)I treatment). This confirmed the higher radiosensitivity of the parotid glands as compared to the submandibular glands. In 12 patients (33%) there was no significant decrease of SEF in the salivary glands after (131)I treatment. The relation between the decrease of SEF after three weeks and after three months and the dose of (131)I administered, was for the right and left submandibular glands significant (P=0.016 and P=0.002), while for the parotid glands it was insignificant (P=0.22 and P=0.27 respectively) (Table 4). Reduction of SEF in the parotid glands three months after (131)I treatment was greater than after three weeks. This difference, as regards the submandibular glands, was not significant. Our results show that high dose (131)I treatment in DTC patients induces a significant effect on salivary gland function, which is dose-related in the submandibular glands, and more prominent in the parotid glands.
涎腺炎和口干症是分化型甲状腺癌（DTC）患者接受高剂量放射性碘（¹³¹I）治疗后众所周知的副作用。本研究旨在对接受¹³¹I治疗甲状腺残余组织和/或转移灶的DTC患者的唾液腺功能进行半定量测定。研究对象为36例患者，其中男性11例，女性25例，平均年龄53.5岁，年龄范围22 - 73岁。采用⁹⁹ᵐTc - 高锝酸盐对唾液腺进行闪烁扫描，并计算腮腺和颌下腺的唾液排泄分数（SEF）作为其功能指标。在¹³¹I治疗前作为基线研究进行测量，以及在治疗后三周和三个月进行测量。通过标准化主观问卷对患者进行临床评估。结果如下：与基线测量相比，¹³¹I治疗后三周和三个月时的平均SEF降低。基线测量、三周后测量和三个月后测量的总平均SEF分别为：54.9%、47.2%和46%；两次测量的P均<0.05（表1）。腮腺SEF的降低大于颌下腺（与¹³¹I治疗前、治疗后三周和三个月时的两个唾液腺相比，P<0.05）。这证实了腮腺比颌下腺具有更高的放射敏感性。12例患者（33%）在¹³¹I治疗后唾液腺的SEF没有显著降低。治疗后三周和三个月时SEF的降低与¹³¹I给药剂量之间的关系，对于右侧和左侧颌下腺具有显著性（P = 0.016和P = 0.002），而对于腮腺则不具有显著性（分别为P = 0.22和P = 0.27）（表4）。¹³¹I治疗后三个月腮腺SEF的降低大于三周后。对于颌下腺而言，这种差异不具有显著性。我们的结果表明，DTC患者接受高剂量¹³¹I治疗对唾液腺功能有显著影响，这在颌下腺中与剂量相关，在腮腺中更为显著。
