Speicheldrüsenschädigung bei Radioiodtherapie – Dosimetrieergebnisse und deren Implikationen

Zusammenfassung

Die Radioiodtherapie ist ein entscheidender Pfeiler in der Therapie des differenzierten Schilddrüsenkarzinoms. Allerdings sind nicht nur die Schilddrüsenkarzinomzellen in der Lage Radioiod zu konzentrieren, sondern auch andere Zellen, die den Natrium-Iodid-Symporter exprimieren – insbesondere auch die großen Kopfspeicheldrüsen. So ist zu erklären, dass die akute und chronische Sialadenitis mit Xerostomie eine der wesentlichen Komplikationen der Radioiodtherapie ist, die die Lebensqualität der Patienten erheblich negativ beeinflussen kann. Ziel dieser Arbeit ist es, die Bedeutung der Speicheldrüsenfunktion zu erläutern und die aktuellen Aspekte der Speicheldrüsendosimetrie bei der Radioiodtherapie zusammenzufassen. Schließlich werden die über Jahrzehnte angewandten Maßnahmen zur Protektion der radiogenen Speicheldrüsenschäden kritisch diskutiert.

Abstract

Radioiodine therapy plays a key role in the management of patients with differentiated thyroid cancer. However, radioiodine is concentrated not only in the target tissues but also by other tissue expressing sodium/iodine symporters – in particular the submandibular and parotid salivary glands. As a consequence, high-activity radioiodine therapy may be associated with unwanted radiogenic salivary gland damages. As a consequence, the most frequently observed adverse short- and long-term side effects of radioiodine therapy include sialoadenitis and some degree of xerostomia, both with a potentially negative impact on quality of life. In this review, we highlight the function and importance of salivary glands and discuss the current results of dosimetry studies of the salivary glands in patients, who undergo radioiodine therapy. Based on the dosimetry findings, the commonly applied radioprotective procedure to diminish damage to the salivary glands are discussed critically.

Schlüsselwörter

Speicheldrüsen - Radioiodtherapie - Nebenwirkungen - Xerostomie - differenziertes Schilddrüsenkarzinom - Dosimetrie - ¹²⁴Iod

Key words

salivary glands - radioiodine therapy - side effects - xerostomia - differentiated thyroid carcinoma - dosimetry - ¹²⁴iodine

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