分化型甲状腺癌^(131)Ⅰ治疗后唾液腺损伤评价及预防  

The Evaluation and Prevention of the Salivary Gland Toxicity of the Differentiated Thyroid Carcinoma after ^(131)Ⅰ Therapy

作　　者：张行涛[1] 苏莉[2] 黄诚刚[2] 柳峰[1] 宓平[2] 

机构地区：[1]孝感市中心医院口腔科,湖北孝感432000 [2]孝感市中心医院核医学科

出　　处：《口腔医学研究》2012年第5期472-475,共4页Journal of Oral Science Research

摘　　要：目的:探讨分化型甲状腺癌(differentiated thyroid carcinoma,DTC)的患者经131Ⅰ治疗后,唾液腺损伤的影响因素、评价方法及预防措施。方法:78例分化型甲状腺癌的患者经手术切除后行大剂量的131Ⅰ治疗,在131Ⅰ治疗前和治疗后的6个月～3年随访唾液腺功能显像。并进行治疗后传统的唾液腺损伤防护和唾液腺损伤综合预防。结果:78例DTC患者中有23例57次出现急性唾液腺损伤;共有22例(28.2%)出现慢性唾液腺损伤;131Ⅰ治疗累积131Ⅰ剂量、131Ⅰ治疗次数、甲状腺癌转移类型与慢性唾液腺损伤的发生率明显相关。唾液腺损伤的综合预防较传统的预防措施可使急性损伤发生率减少31.1%,慢性唾液腺损伤发生率减少17.7%。结论:甲状腺癌131Ⅰ治疗后唾液腺损伤与131Ⅰ治疗累积剂量、131Ⅰ治疗次数、甲状腺癌转移类型有关,唾液腺损伤的综合预防明显优于传统的预防措施。Objective： To explore the influencing factors, evaluation methods and preventive measures of the differ- entiated thyroid carcinoma （DTC） patients＇ salivary gland toxicity after ^ 131Ⅰ therapy. Methods： After surgical ex- cision, 78 patients with differentiated thyroid carcinoma were largely performed ^131 Ⅰ therapy. The salivary gland function imagings from pre--treatment＇s half of the year to post-treatment＇s 3 years following up were studied, and the patients underwent traditional protection and comprehensive prevention of the salivary gland toxicity after treatment. Results： 23 of the 78 DTC patients with acute salivary gland toxicity for 57 times, while 22 （28.2%） ca- ses with chronic salivary gland toxicity. The accumulate 13~Ⅰ amounts and treatment times of the^ 131Ⅰ therapy, and metastasis types of thyroid carcinoma had an obvious relation to the incidence of chronic salivary gland toxicity. The comprehensive prevention of the salivary gland toxicity, compared with the traditional measure, could make the in- cidence of acute salivary gland toxicity decrease by 31.10%, and that of chronic salivary gland toxicity reduce by 17. 7%. Conclusion： The salivary gland toxicity after ^ 131Ⅰ therapy has a relation to the accumulate ^ 131 Ⅰ amounts and treatment times of the^ 131Ⅰ therapy, and metastasis types of thyroid carcinoma. And the comprehensive prevention of the salivary gland toxicity is significantly better than the traditional measure.

关 键 词：甲状腺癌 131Ⅰ治疗 唾液腺损伤 预防 

分 类 号：R736.1[医药卫生—肿瘤]