Salivary and Lacrimal Gland Dysfunction After Remnant Ablation with Radioactive Iodine in Patients with Differentiated Thyroid Carcinoma Prepared with Recombinant Human Thyrotropin

Rosário, Pedro Weslley; Calsolari, Maria Regina

doi:10.1089/thy.2012.0050

Cited by 40 publications

(19 citation statements)

References 9 publications

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“…This is in contrast to a recent study in which all eight patients who had oral symptoms consistent with salivary dysfunction 12 months after RAI therapy were reported to have their salivary dysfunction confirmed by salivary scintigraphy (25). However, the particular deficit noted on scintigraphy (parotid vs. submandibular gland, accumulation vs. secretion) was not reported.…”

Section: Discussioncontrasting

confidence: 99%

Salivary Function after Radioiodine Therapy: Poor Correlation between Symptoms and Salivary Scintigraphy

2015

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ObjectiveSymptoms of salivary gland dysfunction frequently develop after radioactive iodine (RAI) therapy, but have generally not been correlated with assessment of salivary gland functioning. The aim of this study was to determine whether there was a correlation between salivary symptoms and salivary functioning as assessed by salivary scan parameters.MethodsThis was a non-randomized observational study. Fifteen patients receiving RAI therapy for differentiated thyroid cancer completed a questionnaire assessing their salivary and nasal symptoms prior to their therapy and 3 and 12 months after their therapy. Salivary gland scanning using technetium-99m pertechnetate was performed at the same time points. In addition, protective measures used at the time of radioiodine administration, such as use of fluids and sour candy, were also documented. Measures of salivary gland accumulation and secretion were correlated with scores of salivary and nasal symptomatology and any effects of protective measures were assessed.ResultsThe mean number of salivary, nasal, and total symptoms at 3 months increased significantly over the number of symptoms at baseline by 3.7, 2.7, and 6.3 symptoms, respectively (p values 0.001, 0.0046, and <0.001, respectively). The mean increases in the number of salivary, nasal, and total symptoms at 12 months were non-significant at 1.3, 1.3, and 2.5 symptoms, respectively. The mean right parotid gland accumulation and secretion of radioisotope declined significantly at 3 months, compared with baseline. The changes in left parotid and right and left submandibular function were non-significant. There was no association between the increase in salivary, nasal, or total symptoms and the change in scintigraphy measures. However, the increases in nasal and total symptoms were significantly greater in those with co-existent Hashimoto’s disease, compared with those without this condition (p values 0.01 and 0.04, respectively). Nasal symptoms decreased (p value 0.04) and total symptoms trended to decrease (p value 0.08) in those who used sour candies, compared with those who did not. Increasing body mass index was significantly associated with increasing nasal symptoms (p value 0.05). Greater decline in salivary parameters at 3 months compared with baseline was generally associated with heavier body weight, decreased thyroid cancer stage, absence of Hashimoto’s thyroiditis, and pre-menopausal status.ConclusionSalivary and nasal symptoms increased and salivary scintigraphy parameters decreased after radioiodine therapy. However, the increased symptoms did not correlate with decrements in salivary gland accumulation or secretion. Moreover, the variables associated with symptoms and changes in salivary scan parameters differed. Therefore, a better understanding of the relationship between salivary gland symptoms and functioning is needed. Factors affecting susceptibility to salivary and nasal damage after radioiodine therapy need to be better elucidated, so that modifiable factors can be identified.

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Section: Discussioncontrasting

confidence: 99%

Salivary Function after Radioiodine Therapy: Poor Correlation between Symptoms and Salivary Scintigraphy

2015

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“…The finding of the parotid gland being more susceptible to the radiation effect of 131 I was supported by some other studies [25][26][27][28]. Salivary damage seems to be less serious on using rhTSH, compared with of levothyroxine withdrawal [29].…”

Section: Sialadenitis/xerostomiamentioning

confidence: 52%

Adverse effects of radioactive iodine-131 treatment for differentiated thyroid carcinoma

Fard-Esfahani

Emami-Ardekani²,

Fallahi³

et al. 2014

Nuclear Medicine Communications

144

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Use of radioactive iodine is an essential adjuvant treatment strategy after thyroidectomy in patients with differentiated thyroid carcinoma. Although generally safe, radioiodine therapy has some potential side effects, classified as early and late complications, which we have reviewed in this paper. Early complications include gastrointestinal symptoms, radiation thyroiditis, sialadenitis/xerostomia, bone marrow suppression, gonadal damage, dry eye, and nasolacrimal duct obstruction. The late complications include secondary cancers, pulmonary fibrosis, permanent bone marrow suppression, and genetic effects. As I is an efficacious form of treatment that can significantly decrease the rate of mortality, recurrence, and metastasis, and as the side effects are often minor and well tolerated, radioiodine therapy remains the principal mode of treatment for patients with differentiated thyroid carcinoma.

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“…The clinical symptoms that indicate RAI-related damage include pain/swelling, xerostomia, taste alterations, infection, increase in caries, facial nerve involvement, stomatitis, candidiasis, sialadenitis, and neoplasia [17]. In addition to stomatological complications, xerophthalmia has been reported in patients after remnant ablation with I-131 [18,19]. The complications of I-131 therapy may occur anywhere from within 24 h to a few weeks, months, or years following RAI treatment [20,21].…”

Section: Discussionmentioning

confidence: 99%

Systematic evaluation of salivary gland damage following I-131 therapy in differentiated thyroid cancer patients by quantitative scintigraphy and clinical follow-up

Feng²,

Ouyang³

et al. 2015

Nuclear Medicine Communications

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Salivary and Lacrimal Gland Dysfunction After Remnant Ablation with Radioactive Iodine in Patients with Differentiated Thyroid Carcinoma Prepared with Recombinant Human Thyrotropin

Cited by 40 publications

References 9 publications

Salivary Function after Radioiodine Therapy: Poor Correlation between Symptoms and Salivary Scintigraphy

Salivary Function after Radioiodine Therapy: Poor Correlation between Symptoms and Salivary Scintigraphy

Adverse effects of radioactive iodine-131 treatment for differentiated thyroid carcinoma

Systematic evaluation of salivary gland damage following I-131 therapy in differentiated thyroid cancer patients by quantitative scintigraphy and clinical follow-up

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