Post-irradiation hyperamylasemia as a biological dosimeter.
Serum alpha-amylase was measured before and 24 h after either total body (31 patients) or localized irradiation including the salivary glands (40 patients) or the pancreatic area (22 patients). A significant increase in amylasemia was observed for doses to the parotid glands larger than 0.5 Gy. A sigmoid function of dose was fitted to the data and predicted a maximum amylasemia level for doses larger than 4 Gy and smaller than 10 Gy. The raw data from other published series were adequately described by the same model. However, the confidence limits of the parameters remained wide, because of a considerable interindividual variability. Post-irradiation hyperamylasemia appears to provide a good criterion for triage of accidentally irradiated patients: 24 h after a dose larger than 2 Gy to the parotid glands, 91% of the patients had an amylasemia level higher than 2.5-fold the upper normal value (sensitivity). Conversely, 96% had their serum amylasemia lower than 2.5-fold the upper normal value when dose was smaller than 2 Gy (specificity). However, a retrospective estimation of the absorbed dose (dosimetry) is not likely to be very precise because of the large interindividual variability.
Dubray
B
B
Department of Biomathematics, M.D. Anderson Cancer Center, Houston, TX 77033.
Girinski
T
T
Thames
H D
HD
Becciolini
A
A
Porciani
S
S
Hennequin
C
C
Socié
G
G
Bonnay
M
M
Cosset
J M
JM
D000328:Adult; D004796:Clinical Enzyme Tests; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D015182:Lymphatic Irradiation / Q000009:adverse effects; D010306:Parotid Gland / Q000528:radiation effects*; D011446:Prospective Studies; D011832:Radiation Injuries / Q000097:blood / Q000175:diagnosis*; D011874:Radiometry; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D013997:Time Factors; D014916:Whole-Body Irradiation / Q000009:adverse effects; D000516:alpha-Amylases / Q000097:blood*
D000516:alpha-Amylases