Division of Nuclear Medicine, Department of Medicine, Washington Hospital Center and Professor of Medicine, Georgetown University School of Medicine, Washington, DC 20010, USA.
Oral Dis. 2011 Mar;17(2):154-61. doi: 10.1111/j.1601-0825.2010.01726.x. Epub 2010 Oct 28.
Radioiodine (¹³¹I) is an important therapy for patients who have well-differentiated thyroid cancer. However, ¹³¹I may also result in side effects in multiple organs and glands. The glands that are frequently affected are the salivary glands with the major untoward effects including sialoadenitis and increased risk of second primary malignancy. This report will review sialoadenitis secondary to ¹³¹I therapy including (1) proposed mechanisms, (2) incidence and clinical presentations, (3) possible approaches to improve prevention, (4) management, and (5) sequelae of sialoadenitis (e.g. xerostomia and salivary duct obstruction). A discussion of second primary malignancies is beyond the scope of this review. With a better understanding of the above, dentists, oral surgeons, otolaryngologists, endocrinologists, nuclear medicine physicians, and nuclear radiologists will be more likely to implement more effective preventive measures to reduce the incidence and severity of ¹³¹I-induced sialoadenitis, and if it does occur, to identify and treat sialoadenitis sooner, thereby potentially reducing not only the severity of the initial symptoms, but also the severity of subsequent sequelae.
放射性碘(¹³¹I)是治疗分化型甲状腺癌患者的重要手段。然而,¹³¹I 也可能导致多个器官和腺体的副作用。受影响最频繁的腺体是唾液腺,其主要不良影响包括唾液腺炎和第二原发恶性肿瘤风险增加。本报告将回顾¹³¹I 治疗引起的唾液腺炎,包括(1)提出的机制,(2)发病率和临床表现,(3)改善预防的可能方法,(4)管理,以及(5)唾液腺炎的后遗症(例如口干和唾液管阻塞)。第二原发恶性肿瘤的讨论超出了本综述的范围。通过更好地了解上述情况,牙医、口腔外科医生、耳鼻喉科医生、内分泌学家、核医学医师和核放射学家将更有可能实施更有效的预防措施,以降低¹³¹I 诱导的唾液腺炎的发病率和严重程度,如果确实发生,将更早地识别和治疗唾液腺炎,从而不仅可能减轻初始症状的严重程度,还可能减轻后续后遗症的严重程度。