Salivary gland function in thyroid cancer patients with radioiodine administration history

Abstract

Aim. Radioiodine (RAI) improves survival in patients with locally advanced or metastatic differentiated thyroid carcinoma (DTC). Although there has been an ongoing debate on RAI-induced salivary gland damage, published data have been inconsistent. Therefore, the purpose of our study was to compare salivary gland function in intermediate and high risk DTC patients after single or repeated RAI treatment with their age-and sex-matched RAI-naive counterparts. Methods. Uptake and excretion of parotid and submandibular glands were quantitatively evaluated using 99m Tc-pertechnetate salivary gland scintigraphy in 23 patients previously treated with RAI. Patients (median 9.25 GBq 131 I-NaI; Q1-Q3: 5.55-16.65; range: 5.55-27.5) were divided into subgroups according to previously administered 131 I-NaI activity using cut-off values 5.55 GBq and 9.25 GBq. Their salivary gland scintigraphy results were compared with RAI-naive patients using Mann-Whitney test. Results. Compared to RAI-naive patients, parotid glands pertechnetate uptake was significantly lower in those treated with > 9.25 GBq (P=0.034) and parotid glands excretion fraction was already decreased with RAI activities > 5.55 GBq (P=0.031). In submandibular glands, no statistically significant difference in either function was observed even with RAI activity > 9.25 GBq. Conclusion. Our data suggest that RAI therapy using activities ≤ 5.55 GBq does not substantially decrease saliva production. Activities > 5.55 GBq may lead to significant decrease in parotid excretion, and activities > 9.25 GBq also diminish parotid uptake. Surprisingly, submandibular glands, providing majority of seromucinous saliva under basal condition, seem to be unaffected even by RAI activities above 9.25 GBq.

The RAI-6 Questionnaire: A New Screening Questionnaire to Monitor Complications of Radioiodine Treatment

“…Statistical analysis of our study data demonstrated that a worse score on the RAI-6 questionnaire does correlated with the radioiodine dose given. Our study results are comparable with the studies by Almeida et al ( 14 ), Krcalova et al ( 27 ), and Fard-Esfahani et al ( 28 ). The study by Almeida et al showed that doses higher than 150 mCi have more side effects on salivary glands ( 13 ).…”

“…The study by Almeida et al showed that doses higher than 150 mCi have more side effects on salivary glands ( 13 ). Krcalova et alconcluded that RAI therapy up to 5.55 GBq (150 mCi) does not substantially decrease saliva production ( 27 ). Fard-Esfahani et al suggested that RAIS is more frequent in differentiated thyroid cancer patients, with the higher dose of 100 mCi, compared to patients treated for hyperthyroidism with doses <30 mCi ( 28 ).…”