Longitudinal scintigraphic study of parotid and submandibular gland function after total body irradiation in children and adolescents.
OBJECTIVE
Total body irradiation (TBI) and cyclophosphamide (CY) during allogeneic stem cell transplantation (ASCT) cause salivary gland dysfunction in children. The aim of this investigation was to study the scintigraphic functional changes over time of the parotid and submandibular glands in children and young adults one year after treatment with CY and TBI at ASCT.


METHODS
Salivary gland scintigraphy (SGS) was performed before ASCT, and 3-6 months and 12 months after ASCT. The three male patients who fulfilled the scintigraphic study had a mean age (+/- SD) of 17.3 +/- 9.8 years at ASCT.


RESULTS
The parotid secretion capacity (SPar) was 83.5 +/- 3.2% before ASCT and 48.5 +/- 25.8% during the next 3-6 months (P < 0.05). The SPar did not increase (48.1 +/- 12.4%) during the rest of the first year after ASCT. The submandibular emptying capacity (SSub) was 91.3 +/- 12.9% before ASCT and 35.4 +/- 2.3% after 3-6 months (P < 0.05). The SSub was 87.9 +/- 17.9% one year after ASCT.


CONCLUSIONS
The parotid glands were more sensitive to irradiation since they did not recover lost capacity to secrete saliva, while the submandibular glands recovered the secretion capacity at the one-year follow-up.
Bågesund
Mats
M
Department of Paediatric Dentistry, Karolinska Institute, Stockholm, Sweden. mats.bagesund@lio.se
Richter
Sven
S
Ringdén
Olle
O
Dahllöf
Göran
G
D000293:Adolescent; D000328:Adult; D002648:Child; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D010306:Parotid Gland / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000378:metabolism / Q000528:radiation effects; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012472:Salivation / Q000187:drug effects / Q000528:radiation effects; D012636:Secretory Rate / Q000187:drug effects / Q000528:radiation effects; D033581:Stem Cell Transplantation; D013363:Submandibular Gland / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000378:metabolism / Q000528:radiation effects; D013667:Technetium; D019172:Transplantation Conditioning; D014916:Whole-Body Irradiation
D019653:Myeloablative Agonists; D019275:Radiopharmaceuticals; D013667:Technetium; D003520:Cyclophosphamide