Document Detail


Salivary gland function 5 years after radioactive iodine ablation in patients with differentiated thyroid cancer: direct comparison of pre- and postablation scintigraphies and their relation to xerostomia symptoms.
MedLine Citation:
PMID:  23153322     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Chronic sialadenitis is one of the most frequent chronic complications after radioactive iodine (RAI) therapy for thyroid cancer. To evaluate the long-term effects of RAI ablation on salivary gland function, we investigated scintigraphic changes in salivary glands by direct comparison of two salivary gland scintigraphies (SGSs) taken before and at 5 years after an RAI ablation.
METHODS: SGS was performed just before RAI ablation (pre-SGS) and ∼5 years after RAI ablation (F/U SGS) in 213 subjects who underwent thyroidectomy for thyroid cancer. The uptake score (U score) was graded, and the ejection fraction (EF) was quantified for the parotid and submandibular glands at pre-SGS and F/U SGS. Changes in salivary gland function were graded as mild, moderate, or severe according to the differences in U score and EF between the two SGSs. Xerostomia was assessed and compared with the SGS findings.
RESULTS: Worsening of the U score was observed in 182 of 852 salivary glands (total: 21.3%; mild: 4.2%, moderate: 7.4%, severe: 9.7%), and 47.4% of the patients had a worsening U score for at least one of four salivary glands. A decrease in EF was observed in 173 of 852 salivary glands (total: 20.3%; mild: 5.4%, moderate: 6.8%, severe: 8.1%), and 43.7% of the patients experienced a decrease in the EF of at least one of the four salivary glands. Bilateral parotid gland dysfunction was the most commonly observed condition. Thirty-five (16.4%) patients complained of xerostomia at 5 years after RAI ablation. Scintigraphic changes in salivary gland function and xerostomia were more common in patients receiving 5.55 GBq, compared with 3.7 GBq. Xerostomia was more common in patients with submandibular gland dysfunction than those with parotid gland dysfunction (68.8% vs. 33.3%, p<0.05). The number of dysfunctional salivary glands was correlated with xerostomia (p<0.01).
CONCLUSION: About 20% of the salivary glands were dysfunctional on SGS 5 years after a single RAI ablation, especially in patients who received higher doses of RAI. While parotid glands are more susceptible to (131)I-related damage, xerostomia was more associated with submandibular gland dysfunction and the prevalence of dysfunctional salivary glands.
Authors:
Shin Young Jeong; Hae Won Kim; Sang-Woo Lee; Byeong-Cheol Ahn; Jaetae Lee
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-04-18
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  23     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-30     Completed Date:  2013-11-14     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  609-16     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Combined Modality Therapy / adverse effects
Dose-Response Relationship, Radiation
Female
Follow-Up Studies
Humans
Iodine Radioisotopes / administration & dosage,  adverse effects*,  diagnostic use,  therapeutic use
Male
Middle Aged
Prevalence
Radiopharmaceuticals / administration & dosage,  adverse effects*,  diagnostic use,  therapeutic use
Republic of Korea / epidemiology
Salivary Glands / physiopathology*,  radiation effects,  radionuclide imaging,  secretion
Severity of Illness Index
Sialadenitis / epidemiology,  etiology,  physiopathology*,  radionuclide imaging
Submandibular Gland / physiopathology,  radiation effects,  radionuclide imaging,  secretion
Submandibular Gland Diseases / epidemiology,  etiology,  physiopathology*,  radionuclide imaging
Thyroid Neoplasms / physiopathology,  radiotherapy*,  surgery
Thyroidectomy
Xerostomia / epidemiology,  etiology,  physiopathology*,  radionuclide imaging
Young Adult
Chemical
Reg. No./Substance:
0/Iodine Radioisotopes; 0/Radiopharmaceuticals
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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