氨磷汀在高剂量放射性碘治疗中对唾液腺的辐射防护作用。

Radioprotection of salivary glands by amifostine in high-dose radioiodine therapy.

作者信息

Bohuslavizki K H, Brenner W, Klutmann S, Hübner R H, Lassmann S, Feyerabend B, Lüttges J, Tinnemeyer S, Clausen M, Henze E

机构信息

Clinic of Nuclear Medicine and Department of Pathology, Christian-Albrechts-University, Kiel, Germany.

出版信息

J Nucl Med. 1998 Jul;39(7):1237-42.

PMID:9669401

Abstract

UNLABELLED

Salivary gland impairment after high-dose radioiodine treatment is well recognized. Because differentiated thyroid cancer has a good prognosis, reduction of long-term side effects is important. This study investigated the radioprotective effects of amifostine in animals and humans receiving high-dose radioiodine therapy.

METHODS

Quantitative salivary gland scintigraphy was performed in five rabbits before and up to 3 mo after high-dose radioiodine therapy applying 1 GBq 131I. Three animals received 200 mg/kg amifostine before high-dose radioiodine therapy, and two served as controls. All animals were examined histopathologically. Quantitative salivary gland scintigraphy also was performed in 17 patients with differentiated thyroid cancer before and 3 mo after high-dose radioiodine therapy with 6 GBq 131I. Eight patients were treated with 500 mg/m2 amifostine before high-dose radioiodine therapy, and nine served as controls.

RESULTS

In two control rabbits, high-dose radioiodine therapy significantly reduced parenchymal function by 63% and 46% in parotid and submandibular glands, respectively. In contrast, there was no significant decrease in parenchymal function in amifostine-treated animals. Histopathologically, lipomatosis was observed in control animals but was negligible in amifostine-treated animals. Similar findings were observed in differentiated thyroid cancer patients. In nine control patients, high-dose radioiodine therapy significantly (p < 0.01) reduced parenchymal function by 37% and 31% in parotid and submandibular glands, respectively. Three patients exhibited Grade I (World Health Organization) xerostomia. In contrast, there was no significant decrease in parenchymal function in amifostine-treated patients and no incidence of xerostomia.

CONCLUSION

Parenchymal damage in salivary glands induced by high-dose radioiodine therapy can be reduced significantly by amifostine. This may increase the quality of life of patients with differentiated thyroid cancer.

摘要

未标注

高剂量放射性碘治疗后唾液腺损伤已得到充分认识。由于分化型甲状腺癌预后良好，减少长期副作用很重要。本研究调查了氨磷汀对接受高剂量放射性碘治疗的动物和人类的辐射防护作用。

方法

对5只兔子在给予1GBq 131I高剂量放射性碘治疗前及治疗后长达3个月进行定量唾液腺闪烁扫描。3只动物在高剂量放射性碘治疗前接受200mg/kg氨磷汀，2只作为对照。所有动物均进行组织病理学检查。对17例分化型甲状腺癌患者在给予6GBq 131I高剂量放射性碘治疗前及治疗后3个月也进行了定量唾液腺闪烁扫描。8例患者在高剂量放射性碘治疗前接受500mg/m2氨磷汀治疗，9例作为对照。

结果

在2只对照兔子中，高剂量放射性碘治疗使腮腺和颌下腺的实质功能分别显著降低63%和46%。相比之下，氨磷汀治疗的动物实质功能没有显著下降。组织病理学检查发现，对照动物出现脂肪化生，但在氨磷汀治疗的动物中可忽略不计。在分化型甲状腺癌患者中也观察到类似结果。在9例对照患者中，高剂量放射性碘治疗使腮腺和颌下腺的实质功能分别显著（p<0.01）降低37%和31%。3例患者出现I级（世界卫生组织）口干症。相比之下，氨磷汀治疗的患者实质功能没有显著下降，也没有口干症发生。