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唾液腺内镜检查对改善放射性碘诱导的口干症患者健康相关生活质量的影响。

Impact of sialendoscopy on improving health related quality of life in patients suffering from radioiodineinduced xerostomia.

作者信息

Bulut Olcay Cem, Haufe Sabine, Hohenberger Ralph, Hein Matti, Kratochwil Clemens, Rathke Hendrik, Plinkert Peter K, Baumann Ingo, Holland-Letz Tim, Haberkorn Uwe, Flechsig Paul

出版信息

Nuklearmedizin. 2018 Aug;57(4):160-167. doi: 10.3413/Nukmed-0964-18-03. Epub 2018 Aug 20.

Abstract

INTRODUCTION

Xerostomia following radioiodine therapy (RIT) in patients suffering from differentiated thyroid cancer is a common side effect in 2 % to 67 % of patients treated with radioiodine (I-131). In order to evaluate the impact of sialendoscopy on health related quality of life (HRQOL) in patients suffering from therapy induced sialadenitis and xerostomia, we analyzed findings from two dedicated questionnaires (Xerostomy Questionnaire XQ and Xerostomy Inventory XI) in patients before and three months after sialendoscopy.

PROCEDURES

In total, 12 patients suffering from differentiated thyroid carcinoma (10 women and 2 men) were evaluated. All patients had experienced conservative management. Patients were offered a sialendoscopy procedure if no major contradictions were present. Patients who denied the procedure formed the control group. Pre- and (three months) postoperative HRQOL was measured with the Patient Reported Outcome Measures (PROM) Xerostomia Questionnaire (XQ) and the Xerostomia Inventory (XI), as well as by a pre- and post-interventional salivary gland scintigram. Patients were graded according to their sialendoscopical findings.

RESULTS

Interventional group presented with significant improvements in HRQOL measurements regarding XQ and XI-scores three months postoperatively. Control group showed no significant changes in the XQ or the XI scores. Number of RIT and cumulative activity of I-131 did not correlate with higher disease grade in regards to sialendoscopical findings nor did it correlate with higher XQand XI scores. Pre- and post-interventional salivary gland scintigram stated that parotid glands are more severely damaged than submandibular glands (SMG), but no significant scintigraphically changes could be detected after sialendoscopy.

CONCLUSION

Sialendoscopy in patients suffering from therapy induced sialadenitis and xerostomia seems to be beneficial when evaluating the impact on HRQOL. Functional parameters measured by salivary gland scintigram did not show significant changes in post-interventional scintigrams.

摘要

引言

分化型甲状腺癌患者接受放射性碘治疗(RIT)后出现口干是一种常见的副作用,在接受放射性碘(I-131)治疗的患者中,发生率为2%至67%。为了评估唾液腺内镜检查对治疗引起的涎腺炎和口干患者健康相关生活质量(HRQOL)的影响,我们分析了12例患者在唾液腺内镜检查前和检查后三个月时,通过两份专门问卷(口干问卷XQ和口干量表XI)得出的结果。

方法

共评估了12例分化型甲状腺癌患者(10名女性和2名男性)。所有患者均接受过保守治疗。若不存在重大禁忌证,为患者提供唾液腺内镜检查。拒绝该检查的患者组成对照组。术前和术后(三个月)使用患者报告结局测量(PROM)口干问卷(XQ)、口干量表(XI)以及介入前后的唾液腺闪烁显像评估HRQOL。根据唾液腺内镜检查结果对患者进行分级。

结果

干预组术后三个月时在XQ和XI评分的HRQOL测量中表现出显著改善。对照组的XQ或XI评分无显著变化。放射性碘治疗次数和I-131的累积活度与唾液腺内镜检查结果中的更高疾病分级无关,也与更高的XQ和XI评分无关。介入前后的唾液腺闪烁显像表明,腮腺比下颌下腺(SMG)受损更严重,但唾液腺内镜检查后未发现闪烁显像有显著变化。

结论

对于评估对HRQOL的影响,唾液腺内镜检查对治疗引起的涎腺炎和口干患者似乎有益。唾液腺闪烁显像测量的功能参数在介入后的闪烁显像中未显示出显著变化。

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