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131I治疗是DTC患者术后综合治疗(包括清甲治疗、辅助治疗和清灶治疗)的主要方法之一,其疗效确切且安全有效,目前已被广泛应用。131I清除残留甲状腺、潜在DTC转移灶及远处转移灶是基于甲状腺细胞和DTC细胞存在钠碘同向转运体(sodium iodide symporter, NIS)的表达,而在一些非甲状腺组织(如胃黏膜、泪腺和唾液腺等,尤其是唾液腺的纹状管)中也存在着丰富的NIS蛋白[1]。Krcalova等[2]的研究结果显示,DTC患者术后行131I治疗后,唾液腺的摄取和排泌功能均受到不同程度地损伤,其发生率为46.0%~78.1%。减少131I对DTC患者唾液腺的辐射损伤,切实提高其生存质量尤为重要。我们综述了DTC患者术后行131I治疗对唾液腺的辐射损伤及其防治的研究进展。
131I致分化型甲状腺癌患者唾液腺辐射损伤及其防治的研究进展
Research progress on radiation injury of salivary gland and its prevention and treatment in patients with differentiated thyroid cancer induced by 131I
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摘要: 131I治疗分化型甲状腺癌(DTC)的技术成熟、效果显著,是DTC患者术后综合治疗的主要方法之一,目前已被广泛应用于临床。但其造成的唾液腺辐射损伤(口干、腮腺肿痛、味觉改变等)会对DTC患者的生活质量造成一定影响。近年来,各种唾液腺辐射损伤防护剂层出不穷,但其确切疗效较为局限,且治疗方案尚未规范统一。笔者就DTC患者术后行131I治疗对唾液腺的辐射损伤及其防治的研究进展进行综述。Abstract: 131I therapy for differentiated thyroid cancer (DTC) is a mature technology with remarkable effects. As one of the main methods of postoperative comprehensive treatment for patients with DTC, it has been widely used in clinical. But the resulting manifestations of salivary gland radiation injury (dry mouth, parotid gland swelling pain, and taste alteration, etc.) have a certain impact on DTC patients' survival quality. In recent years, various salivary gland radiation injury protective agents have emerged, but their exact efficacy is limited and the treatment plan has not been standardized and unified. The author reviews the research progress on radiation injury of salivary gland and its prevention and treatments in DTC patients treated with 131I after operation.
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Key words:
- Sialadenitis /
- Differentiated thyroid cancer /
- Iodine radioisotopes /
- Radiation injuries
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