Salivary gland toxicity after radioiodine therapy for thyroid cancer
Salivary gland toxicity after radioiodine therapy for thyroid cancer
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DOI：
10.1016/j.clon.2006.11.005
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发表时间：
2007-02-01
影响因子：
3.4
通讯作者：
Harmer, C.
中科院分区：
文献类型：
--
作者：
Hyer, S.;Kong, A.;Harmer, C.
目的：唾液腺毒性是一种常见的，但没有广泛认识到，高剂量放射性碘（I-131）的不良反应。本研究进行了确定的发病率的唾液腺损伤的症状后，I-131治疗分化型甲状腺cancer.Materials和方法：这是一项前瞻性研究，76例连续参加甲状腺癌治疗。在住院期间和随访访视时评估唾液腺损伤症状（口干、疼痛和肿胀）。此外，进行了回顾性分析，在我们的数据库中记录的患者有慢性唾液腺肿胀后I-131 ablation.Results：20例（26%）发展唾液腺毒性，11（15%）的症状在第一个48小时内，持续12个月，在这些患者中的7。另外9名（12%）症状持续的患者直到治疗后3个月才出现毒性反应。总共有16例（21%）患者在12个月时有慢性毒性的证据，通常为口干症。毒性在重复I-131给药后更常见。在检索我们的甲状腺癌数据库后，我们确定了另外5例患者在I-131给药后20个月至23年出现慢性涎腺肿胀（慢性涎腺炎或多形性腺瘤）。结论：I-131给药后疼痛、肿胀和口干频繁发生，部分症状在给药后数月或数年出现。早期识别唾液腺并发症可能有助于降低这些患者的发病率。
Aims: Salivary gland toxicity is a common, but not widely appreciated, adverse effect of high-dose radioiodine (I-131). This study was carried out to determine the incidence of symptoms of salivary gland damage after I-131 treatment for differentiated thyroid cancer.Materials and methods: This was a prospective study of 76 consecutive patients attending thyroid cancer treatment. Symptoms of salivary gland damage (dry mouth, pain and swelling) were assessed during hospital admission and at follow-up visits. Additionally, a retrospective analysis was carried out of patients recorded in our database as having chronic salivary gland swelling after I-131 ablation.Results: Twenty patients (26%) developed salivary gland toxicity, 11 (15%) had symptoms within the first 48 h, continuing for 12 months in seven of these patients. The onset of toxicity in a further nine (12%) patients with persistent symptoms did not occur until 3 months after therapy. In total, 16 (21%) patients had evidence of chronic toxicity, typically xerostomia, at 12 months. Toxicity was more common after repeated I-131 administration. After searching our thyroid cancer database, we identified an additional five patients to have chronic salivary gland swelling (chronic sialadenitis or pleomorphic adenoma) 20 months to 23 years after I-131.Conclusions: Pain, swelling and dry mouth occurred frequently after I-131, with some developing symptoms months or years after administration. Early recognition of salivary gland complications may help to reduce morbidity in these patients.