Sialadenitis as a complication of radioiodine therapy in patients with thyroid cancer: where do we stand?

Adramerinas, Marios; Andreadis, Dimitrios; Vahtsevanos, Konstantinos; Poulopoulos, Athanasios; Pazaitou‐Panayiotou, Kalliopi

doi:10.1007/s42000-021-00304-3

Cited by 15 publications

(18 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Early and comprehensive treatment improved both early and late outcomes and quality of life. 29 The present study underlined the value of ultrasonography as an effective tool in the surveillance of potential malfunction and sialadenitis after RAI treatment. However, the onset of sialadenitis and the pathologic sonographic changes are highly variable 25 and may be delayed.…”

Section: Discussionmentioning

confidence: 60%

See 1 more Smart Citation

Ultrasonographic Features of Salivary Glands after Radioiodine Therapy in Patients with Thyroid Cancer

et al. 2022

View full text Add to dashboard Cite

Objective: Chronic sialadenitis is the most common complication of radioactive iodine (RAI) treatment. The aim of the study was to ascertain sonographic features of the major salivary glands in patients with papillary thyroid cancer (PTC) treated with RAI.Methods: The database of a tertiary medical center was retrospectively searched for consecutive patients who underwent total thyroidectomy for PTC in 2011-2020 with ultrasound follow-up after 1 year. Changes in ultrasound features of the major salivary glands were compared between patients treated or not treated with RAI postoperatively.Results: The cohort included 158 patients, of whom 109 (69%) were treated postoperatively with RAI (mean dose, 131 mCi) and 49 were not (control group). Sonographic changes were observed in the major salivary glands in 43% of the study group and 18% of the control group (p = 0.002), including coarse echotexture, decreased echogenicity, fibrosis, and atrophy. Higher RAI doses were significantly correlated with the prevalence and severity of glandular changes (p < 0.0001).Conclusion: RAI treatment following thyroidectomy is associated with a dose-response effect and adverse changes in the major salivary glands and should be prescribed carefully.

show abstract

Section: Discussionmentioning

confidence: 60%

“…Several studies reported an improvement in symptoms after a single procedure in 50%–100% of patients, mainly attributable to the removal of mucus plugs, stricture dilation, and reduced inflammation. Early and comprehensive treatment improved both early and late outcomes and quality of life 29 …”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic Features of Salivary Glands after Radioiodine Therapy in Patients with Thyroid Cancer

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Ju-qingWu et al [14] obtained similar results. They reported that whereas the parotid glands' function was totally lost, the function of the submandibular glands was only diminished by 14-20% in the group that received the highest dose of radioactive iodine (> 600 mCi).…”

Section: оригінальні дослідженняmentioning

confidence: 60%

“…Подібні результати були отримані і в роботі [14], де функція підщелепних залоз у групі з найвищою дозою радіоактивного йоду (> 600 mCi) була знижена тільки на 14-20%, тоді як функція привушних залоз була втрачена повністю. При цьому, визначення максимальної поглинутої дози за даними сцинтиграфії свідчить, що у підщелепних і привушних залоз вона є співставлюваною.…”

Section: оригінальні дослідженняunclassified

Scintigraphy with 99mTc-pertechnetate in the diagnosis of radiation lesions of the salivary glands after treatment of papillary carcinoma of the thyroid gland

et al. 2023

View full text Add to dashboard Cite

Relevance. The issue of diagnosing and treating of radiation lesions in the salivary glands remains relevant due to the widespread use of radioiodine therapy for highly differentiated thyroid cancer. Sialoscintigraphy with 99mTc-pertechnetate is the most informative method for assessing salivary gland function. There have been few articles on the use of sialoscintigraphy, and it is yet debatable how the clinical, morphological, and functional characteristics of salivary glands exposed to radioiodine therapy relate to one another. The aim of the research was to study the extent and nature of functional disorders of the major salivary glands that occurred in patients after radioiodine therapy for thyroid carcinoma by using sialoscintigraphy with the radiopharmaceutical 99mTc-pertechnetate, as well as the factors affecting the severity of the related disorders. Materials and Methods. Dynamic sialoscintigraphy with 99mTc-pertechnetate [99mTcO4 – ] was used to study the salivary gland function in 30 patients with papillary thyroid carcinoma who developed chronic radiation sialadenitis after total thyroidectomy and radioactive iodine therapy. The findings of the investigations were compared to clinical data. Results and Discussion. Based on sialoscintigraphiic data, substantial abnormalities of the secretory, excretory, and concentration functions of the major salivary glands were found in patients with clinical signs of chronic radiation sialadenitis. The impairments had considerable individual and topographic variability. In most cases, the salivary glands were affected unevenly: against the background of a decrease in or total loss of function of one or more of them, compensatory changes occurred in other glands. Decompensation signs, as evidenced by diminished secretion and concentration capacity, were greater with the decreased excretion ratio (50.0±4.6% of patients) than with the reduced secretory activity ratio (30.0±4.2%) or the concentration ratio (20.8±3.7% of patients). The excretory function of the salivary glands was most negatively impacted; the median value of the excretion ratio was 0.690 (0–0.855 as opposed to the normal range of 0.99–1.02). The median value of the secretion ratio decreased to 1.015 (0.630–1.2 versus the normal range of 1.21–1.26). The nature and severity of the change in sialoscintigraphy indices were not affected by the underlying illness stage or the 131I dose used. Conclusions. Radiation sialoadenitis developing in thyroid cancer patients who undergo thyroidectomy and radioiodine therapy causes persistent functional impairments with significant clinical manifestations. Dynamic sialoscintigraphy with 99mTc-pertechnetate allows objectifying the nature of these functional abnormalities, selecting the optimal therapeutic program, and evaluating the effective of treatment.

show abstract

“…The most common short-term complication of radiation injury to the salivary glands is acute sialadenitis, which occurs within the first 48 h after radioactive iodine ( 5 ) and primarily presents as pain and swelling ( 6 , 7 ). In addition, long-term complications may occur in some cases; these may manifest as chronic sialadenitis where a persistent dry mouth is a prominent symptom ( 6 , 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

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

2022

View full text Add to dashboard Cite

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.

show abstract

Sialadenitis as a complication of radioiodine therapy in patients with thyroid cancer: where do we stand?

Cited by 15 publications

References 68 publications

Ultrasonographic Features of Salivary Glands after Radioiodine Therapy in Patients with Thyroid Cancer

Ultrasonographic Features of Salivary Glands after Radioiodine Therapy in Patients with Thyroid Cancer

Scintigraphy with 99mTc-pertechnetate in the diagnosis of radiation lesions of the salivary glands after treatment of papillary carcinoma of the thyroid gland

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

Contact Info

Product

Resources

About