Marmiroli Luca, Salvi Giovanna, Caiazza Adolfo, Di Rienzo Luigi, Massaccesi Mariangela, Murino Paola, Macchia Gabriella
U.O. Radioterapia, Ospedale Fatebenefratelli S. Giovanni Calibita, Isola Tiberina, 00186 Roma, Italy.
Rays. 2005 Apr-Jun;30(2):145-8.
Radiation-induced xerostomia consists in the chronic dryness of the mouth caused by parotid gland irradiation. Parotid glands produce approximately 60% of saliva while the rest is secreted by submandibular and accessory salivary glands. Methods of measuring the salivary output are essentially represented by 99mTc-pertechnate scintigraphy or simpler albeit less accurate methods in stimulated or unstimulated saliva. There are subjective and objective criteria of classification and grading of the secretion of saliva. Radiation-induced xerostomia, namely the residual salivary gland function is evidently associated with the mean dose absorbed. The salivary output tends to decrease after the end of radiotherapy. The partial dose-volume is substantially correlated with the mean dose to the whole gland. As for ipsilateral irradiation for head and neck cancer, conformal RT or IMRT allow to spare the contralateral parotid gland without increasing the risk of contralateral nodal recurrences. The monitoring system of late toxicity used by the authors is presented.
放射性口干是指腮腺受照射后引起的口腔慢性干燥。腮腺分泌约60%的唾液，其余由颌下腺和副唾液腺分泌。唾液分泌量的测量方法主要有99mTc-高锝酸盐闪烁扫描法，或在刺激或未刺激唾液情况下采用的更简单但准确性稍差的方法。唾液分泌的分类和分级有主观和客观标准。放射性口干，即残余唾液腺功能明显与平均吸收剂量有关。放疗结束后唾液分泌量往往会减少。部分剂量体积与整个腺体的平均剂量密切相关。对于头颈部癌的同侧照射，适形放疗或调强放疗可使对侧腮腺免受照射，而不增加对侧淋巴结复发的风险。文中介绍了作者使用的晚期毒性监测系统。
