Alexander C, Bader J B, Schaefer A, Finke C, Kirsch C M
Department of Nuclear Medicine, Saarland University Medical Center, Homburg/Saar, Germany.
J Nucl Med. 1998 Sep;39(9):1551-4.
The present investigation is an evaluation of intermediate and long-term side effects in patients after high-dose radioiodine treatment due to differentiated thyroid carcinoma.
A total of 203 patients were interviewed using a standardized questionnaire.
After radioiodine treatment, 76.8% of the patients reported intermediate (from discharge up to 3 mo) or long-term (more than 3 mo after treatment) complaints, and 61.1% reported long-term side effects. Nonstochastic side effects included sialoadenitis, which occurred in 33.0% of cases, and 27.1% of patients suffered from a transient loss of taste or smell. More than 1 yr after the last radioiodine application, 42.9% of patients suffered from reduced salivary gland function. Complete xerostomia occurred in 4.4% of patients. Hematological abnormalities were found in 9 patients. In 28.1% of patients a transient episode of alopecia was reported. In 22.7% of patients chronic or recurrent conjunctivitis was reported, and 4 patients underwent dacryocystorhinostomy; 13.8% of patients suffered from an increased frequency of influenza, but 3.4% reported a reduced occurrence of such infections. For sialoadenitis, the loss of taste/smell and dry mouth, the dependence on accumulated activity was significant.
Severe long-term side effects are rare after high-dose radioiodine treatment. Moderate side effects are common. The side effects are commonly the result of radiation damage to the salivary glands. The frequency of such complaints advocates regular protection of the salivary glands.
本研究旨在评估分化型甲状腺癌患者接受高剂量放射性碘治疗后的中长期副作用。
使用标准化问卷对203例患者进行访谈。
放射性碘治疗后，76.8%的患者报告有中期（出院至3个月）或长期（治疗后3个月以上）不适，61.1%的患者报告有长期副作用。非随机副作用包括涎腺炎，发生率为33.0%，27.1%的患者有短暂味觉或嗅觉丧失。最后一次应用放射性碘1年多后，42.9%的患者唾液腺功能减退。4.4%的患者出现完全性口干。9例患者发现血液学异常。28.1%的患者报告有短暂脱发。22.7%的患者报告有慢性或复发性结膜炎，4例患者接受了泪囊鼻腔吻合术；13.8%的患者流感发作频率增加，但3.4%的患者报告此类感染发生率降低。对于涎腺炎、味觉/嗅觉丧失和口干，与累积活度的相关性显著。
高剂量放射性碘治疗后严重的长期副作用罕见。中度副作用常见。副作用通常是唾液腺辐射损伤的结果。此类不适的发生率表明应定期保护唾液腺。
