Abstract
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Objectives: To prospectively use salivary gland dynamic imaging to evaluate the effect of oral vitamin C and sodium bicarbonate on the salivary glands of patients with differentiated thyroid carcinoma (DTC) during high-dose 131I treatment, and to select a more feasible salivary gland protective for patients.
Methods: Prospectively selected 47 patients (18 males and 29 females) after DTC who were planned to undergo the first 131I treatment in the Nuclear Medicine Department of the First Hospital of Shanxi Medical University in 2020, aged (44.81±8.82) years old, and their pathological types were all nipple. The treatment dose was 3700MBq. Among them, 37 cases had cervical lymph node metastasis, 2 cases had lung metastasis, and 1 case had pleural metastasis. They were randomly divided into two groups, the vitamin C group in 25 cases, sodium bicarbonate and vitamin C group in 22 cases. Patients in the vitamin C group received oral 131I treatment 2 hours after oral 131I treatment containing vitamin C tablets, 100mg/2h, 600-800mg/d, 3 days. 2 hours after oral 131I treatment in sodium bicarbonate and vitamin C patients, 1.5g sodium bicarbonate tablets are dissolved in 50ml of water and rinsed in 3 times a day, each rinse for 1 minute, 1 week. And the oral method of vitamin C tablets was the same as before. Treatment in 131I before and one month after treatment, salivary gland dynamic imaging, static total saliva flow rate, saliva PH measurement, serum amylase measurement, and xerostomia questionnaire score were performed to comprehensively evaluate the salivary gland function of 47 patients.
Results: 1. Both groups showed a decrease in the amylase level. The decrease in amylase level in the sodium bicarbonate and vitamin C group was significantly higher than that in the vitamin C group (P<0.05, Table 1). 2. Comparison of dry mouth questionnaire scores between the two groups of patients in different periods: the time effect was statistically significant (F=9.226, P<0.001) and the influence of different intervention methods on the dry mouth questionnaire scores was not statistically significant (F=1.637, P=0.207,Table 2). 3.Comparison of functional parameters of patients after DTC before 131I treatment and one month after treatment: Salivary gland dynamic imaging showed that the uptake index (UI) of the left parotid gland in the vitamin C group was significantly lower than before treatment, and the excretion fraction (EF) of bilateral parotid glands were significantly higher than before treatment (Table 3). The maximum uptake ratio within 20 minutes (UR20) of right parotid gland, and the EF of salivary glands were significantly higher than before treatment in the sodium bicarbonate and vitamin C group (Table 4) (all P<0.05).
Conclusions: In high-dose 131I treatment, vitamin C can improve the excretion function of parotid glands in patients after DTC, while sodium bicarbonate combined with vitamin C can protect the excretion function of salivary glands in patients after DTC.
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