Son Haiyoung, Lee Sang Mi, Yoon Ra Gyoung, Lee Hakmin, Lee Ilkyun, Kim Soon, Chung Woong Youn, Lee Jeong Won
Catholic Kwandong University International St. Mary's Hospital, 25, Simgok-ro 100 beon-gil, Seo-gu, Incheon, 404-834, Korea.
Hell J Nucl Med. 2017 Jan-Apr;20(1):62-70. doi: 10.1967/s002449910508. Epub 2017 Mar 20.
In the current study, we examined whether selenium supplementation during iodine-131 (I) treatment had a radio-protective effect on salivary glands.
Sixteen patients with differentiated thyroid cancer were prospectively enrolled in the study. Patients after total thyroidectomy, before I treatment, were divided into two groups; 8 patients in the selenium group and 8 patients in the control group. Patients in the selenium group received 300νg of selenium orally for 10 days, from 3 days before to 6 days after I treatment. The control group received a placebo over the same period. To assess salivary gland function, salivary gland scintigraphy was performed before and 6 months after I treatment. Serum amylase and whole blood selenium levels were measured before and 2 days and 6 months after I treatment. Using salivary gland scintigraphy, maximum uptake ratio (MUR), maximum secretion percentage (MSP), and ejection fraction (EF) of each salivary gland were calculated.
Baseline clinical characteristics, baseline amylase and selenium levels, and parameters of baseline salivary gland scintigraphy were not significantly different between selenium and control groups (P>0.05). On a blood test performed 2 days after I treatment, the selenium group showed a significantly higher whole blood selenium level (P=0.008) and significantly lower serum amylase level (P=0.009) than the control group. On follow-up salivary gland scintigraphy, the control group showed significantly decreased, MUR of the bilateral parotid and left submandibular glands, MSP of the bilateral parotid and submandibular glands, and EF of the left submandibular glands (P<0.05), while the selenium group only had a significant decrease in MSP of the right submandibular gland and EF of the left submandibular gland (P<0.05).
Selenium supplementation during I treatment was effective to reduce salivary glands damage by I radiation in patients with differentiated thyroid cancer.
在本研究中，我们探讨了在碘-131（I）治疗期间补充硒对唾液腺是否具有放射保护作用。
前瞻性纳入16例分化型甲状腺癌患者。全甲状腺切除术后、I治疗前的患者被分为两组；硒组8例患者，对照组8例患者。硒组患者在I治疗前3天至治疗后6天口服300μg硒，持续10天。对照组在同一时期接受安慰剂。为评估唾液腺功能，在I治疗前及治疗后6个月进行唾液腺闪烁扫描。在I治疗前、治疗后2天和6个月测量血清淀粉酶和全血硒水平。使用唾液腺闪烁扫描计算每个唾液腺的最大摄取率（MUR）、最大分泌百分比（MSP）和排出分数（EF）。
硒组和对照组之间的基线临床特征、基线淀粉酶和硒水平以及基线唾液腺闪烁扫描参数无显著差异（P>0.05）。在I治疗后2天进行的血液检测中，硒组的全血硒水平显著高于对照组（P=0.008），血清淀粉酶水平显著低于对照组（P=0.009）。在随访唾液腺闪烁扫描中，对照组双侧腮腺和左下颌下腺的MUR、双侧腮腺和下颌下腺的MSP以及左下颌下腺的EF显著降低（P<0.05），而硒组仅右下颌下腺的MSP和左下颌下腺的EF显著降低（P<0.05）。
在I治疗期间补充硒可有效减少分化型甲状腺癌患者因I辐射导致的唾液腺损伤。
