Optimal administration time of vitamin C after 131I therapy in differentiated thyroid cancer based on propensity score matching

Abstract

ObjectivesThis study aimed to investigate the protection of the salivary glands by vitamin C administration at 2 and 24 h after an initial treatment using iodine-131 (131I) in patients with differentiated thyroid cancer (DTC) and examined the optimal administration time of vitamin C to protect the salivary glands from radiation injury.MethodThe clinical data of patients with differentiated thyroid carcinoma who had been treated with 131I in the Department of Nuclear Medicine in Shanxi Bethune Hospital from January 2014 to December 2020 were retrospectively analyzed. The propensity score matching method was adopted to match patients who received the administration of vitamin C at 2 h with those receiving administration at 24 h. A total of 230 pairs/460 patients were enrolled in the study. The chi-squared (χ2) or Fisher's exact test was used to compare the indicators representing the incidence of salivary gland injury between the two groups.ResultsThe incidence of salivary gland injury (17.39%) with acidic substances at 2 h was lower compared with administration at 24 h (26.96%). The incidence of acute salivary gland injury (15.22%) and chronic salivary gland injury (26.09%) in the 24-h group were higher than those in the 2-h group (4.78% and 18.26%, respectively). The differences in the left submandibular gland concentrate index and right submandibular gland concentrate index were statistically significant before and after treatment in both the 2 and the 24-h groups; these functions had been impaired after treatment.ConclusionsFollowing treatment with 131I, the protective effect of acidic substances administered at 2 and 24 h on the salivary glands were different. The incidence of salivary gland injury in the 2 h acid stimulation group was lower than in the 24 h acid stimulation group. The present study revealed that 131I treatment did cause some injury to the salivary glands and that the protective effect of administering vitamin C at 2 and 24 h may be limited. Accordingly, protection against salivary gland injury should be conducted using comprehensive measures.

Radioiodine-131 Therapy Used for Differentiated Thyroid Cancer Can Impair Titanium Dental Implants: An In Vitro Analysis

“…), there is damage to acinar cells and the inflammatory effect of salivary ducts lead to fluid reduction and chronic sialadenitis, finally ending with xerostomia [19]. The standard protocol to reduce the salivary gland damage is to stimulate the salivary fluid before and after the therapy with lemon juice, and drops for several hours for 2-3 days [9,10].…”

“…The role of the dental practitioner is to prevent and to erase the oral acute and late side effects of the radioiodine therapy [9]. The effect of radioiodine on salivary glands and its potential inflammatory effect, leading to chronic sialadenitis [9][10][11], is well known; moreover, many publications focus on this side effect and on strategies for preventing its occurrence. Other complications that may arise could be candidiasis, stomatitis, xerostomia, carious lesions, periodontal disease, nerve damage (e.g., facial nerve) or neoplasia [12][13][14][15].…”