Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology

Singer, Michael C.; Marchal, Francis; Angelos, Peter; Bernet, Vic; Boucai, Laura; Buchholzer, S.; Burkey, Brian B.; Eisele, David W.; Erkul, Evren; Faure, Frédéric; Freitag, Suzanne K.; Gillespie, M. Boyd; Harrell, R. Mack; Hartl, Dana M.; Haymart, Megan R.; Leffert, Jonathan; Miller, Barbra S.; Morris, John H.; Pearce, Elizabeth N.; Rahmati, Rahmatullah; Ryan, William R.; Schaitkin, Barry M.; Schlumberger, Martin; Stack, Brendan C.; Nostrand, Doug Van; Wong, Ka Kit; Randolph, Gregory W.

doi:10.1002/hed.26417

Cited by 32 publications

(16 citation statements)

References 104 publications

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“…In fact, in addition to the thyroid gland, the presence of sodium/iodine symporter (NIS) has been shown in several organs, allowing significant iodine uptake, but also leading to an increased susceptibility to adverse events (AEs) during RAI treatments [ 128 ]. The most frequently involved non-thyroidal tissues are the salivary and nasolacrimal glands, but potential toxicity on gastrointestinal tissues, bone marrow, and gonads has also been described during the course of succeeding radioiodine administrations [ 128 , 129 , 130 , 131 , 132 , 133 ]. The real incidence of RAI-related AEs varies, according to the studies and the detection methods.…”

Section: Side Effects Of Raimentioning

confidence: 99%

“…Considering the high rate of salivary gland AEs, several preventive strategies have been investigated in pre-clinical and clinical settings [ 131 , 161 ]. Pre-clinical studies explored the efficacy of various agents, including antioxidants (i.e., Vitamin E) and nutraceutics (i.e., Curcuma longa , Ocimum sanctum , and zinc), showing potential benefits in non-human subject tests [ 161 ].…”

Section: Side Effects Of Raimentioning

confidence: 99%

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Strategies for Radioiodine Treatment: What’s New

Sparano

Moog

Hadoux

et al. 2022

Cancers

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Radioiodine treatment (RAI) represents the most widespread and effective therapy for differentiated thyroid cancer (DTC). RAI goals encompass ablative (destruction of thyroid remnants, to enhance thyroglobulin predictive value), adjuvant (destruction of microscopic disease to reduce recurrences), and therapeutic (in case of macroscopic iodine avid lesions) purposes, but its use has evolved over time. Randomized trial results have enabled the refinement of RAI indications, moving from a standardized practice to a tailored approach. In most cases, low-risk patients may safely avoid RAI, but where necessary, a simplified protocol, based on lower iodine activities and human recombinant TSH preparation, proved to be just as effective, reducing overtreatment or useless impairment of quality of life. In pediatric DTC, RAI treatments may allow tumor healing even at the advanced stages. Finally, new challenges have arisen with the advancement in redifferentiation protocols, through which RAI still represents a leading therapy, even in former iodine refractory cases. RAI therapy is usually well-tolerated at low activities rates, but some concerns exist concerning higher cumulative doses and long-term outcomes. Despite these achievements, several issues still need to be addressed in terms of RAI indications and protocols, heading toward the RAI strategy of the future.

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Section: Side Effects Of Raimentioning

confidence: 99%

Section: Side Effects Of Raimentioning

confidence: 99%

Strategies for Radioiodine Treatment: What’s New

Sparano

Moog

Hadoux

et al. 2022

Cancers

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“…To better characterize the possible relationship and mechanism of RAI‐induced PHPT, larger prospective studies would be needed. RAI is known to have a number of potential side effects and it is possible that the risk of developing PHPT should be added as a potential consideration 27 …”

Section: Discussionmentioning

confidence: 99%

“…RAI is known to have a number of potential side effects and it is possible that the risk of developing PHPT should be added as a potential consideration. 27 As the literature on this topic is limited, the clinical presentation of these patients remains unclear. The latency period from the time of RAI treatment to the development of PHPT is not well studied.…”

Section: Discussionmentioning

confidence: 99%

Hyperparathyroidism subsequent to radioactive iodine therapy for Graves' disease

et al. 2021

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Background The development of primary hyperparathyroidism (PHPT) after radioactive iodine (RAI) treatment for thyroid disease is poorly characterized. The current study is the largest reported cohort and assesses the disease characteristics of patients treated for PHPT with a history of RAI exposure. Methods A retrospective analysis comparing patients, with and without a history of RAI treatment, who underwent surgery for PHPT. Results Twenty‐eight of the 469 patients had a history of RAI treatment, all for Graves' disease. Patients with a history of RAI exposure had similar disease characteristics compared to control; however, patients with a history of RAI treatment had a higher rate of recurrence (7.4% vs 1.2%, p = 0.012). Conclusion PHPT in patients with a history of RAI treatment can be approached in the same manner as RAI naive PHPT patients; however, the risk of recurrence of PHPT in RAI exposed patients may be higher.

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“…A substantial proportion of thyroid cancer sufferers are treated with radioactive iodine (RAI), which is also concentrated in parotid and submandibular glands by expressed sodium iodide membrane symporter proteins. Acute salivary gland hypofunction is seen in the first week following treatment and chronic sialadenitis from 3 mo onward, associated with ductal strictures and obstructive disease, which causes pain and associated salivary gland dysfunction, usually determined by salivary gland scintigraphy (Singer et al 2020).…”

Section: Radioactive Iodine and Radiolabeled Prostate-specific Membrane Antigen Infusionsmentioning

confidence: 99%

Disease-Induced Changes in Salivary Gland Function and the Composition of Saliva

Proctor

Shaalan

2021

J Dent Res

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Although the physiological control of salivary secretion has been well studied, the impact of disease on salivary gland function and how this changes the composition and function of saliva is less well understood and is considered in this review. Secretion of saliva is dependent upon nerve-mediated stimuli, which activate glandular fluid and protein secretory mechanisms. The volume of saliva secreted by salivary glands depends upon the frequency and intensity of nerve-mediated stimuli, which increase dramatically with food intake and are subject to facilitatory or inhibitory influences within the central nervous system. Longer-term changes in saliva secretion have been found to occur in response to dietary change and aging, and these physiological influences can alter the composition and function of saliva in the mouth. Salivary gland dysfunction is associated with different diseases, including Sjögren syndrome, sialadenitis, and iatrogenic disease, due to radiotherapy and medications and is usually reported as a loss of secretory volume, which can range in severity. Defining salivary gland dysfunction by measuring salivary flow rates can be difficult since these vary widely in the healthy population. However, saliva can be sampled noninvasively and repeatedly, which facilitates longitudinal studies of subjects, providing a clearer picture of altered function. The application of omics technologies has revealed changes in saliva composition in many systemic diseases, offering disease biomarkers, but these compositional changes may not be related to salivary gland dysfunction. In Sjögren syndrome, there appears to be a change in the rheology of saliva due to altered mucin glycosylation. Analysis of glandular saliva in diseases or therapeutic interventions causing salivary gland inflammation frequently shows increased electrolyte concentrations and increased presence of innate immune proteins, most notably lactoferrin. Altering nerve-mediated signaling of salivary gland secretion contributes to medication-induced dysfunction and may also contribute to altered saliva composition in neurodegenerative disease.

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Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology

Cited by 32 publications

References 104 publications

Strategies for Radioiodine Treatment: What’s New

Strategies for Radioiodine Treatment: What’s New

Hyperparathyroidism subsequent to radioactive iodine therapy for Graves' disease

Disease-Induced Changes in Salivary Gland Function and the Composition of Saliva

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