Skip to main content
SpringerLink
Log in

Moderate to severe nausea in radioactive iodine (RAI) therapy is associated with the RAI dose per body weight and was not prevented by ramosetron

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

To retrospectively analyze the individual risk factors for radioactive iodine (RAI)-associated nausea and vomiting, and to examine the anti-emetic effect of ramosetron (5-hydroxytryptamine-3 receptor antagonist) in RAI therapy. Patients with differentiated thyroid carcinoma who underwent first-time RAI therapy at Nagasaki University Hospital between January 2009 and 2013 were included (N = 81). As a routine treatment, all patients were administered 30 mg of domperidone per day. Patients who underwent RAI therapy between April 2011 and January 2013 were also administered 0.1 mg of ramosetron per day in addition to domperidone. Nausea and vomiting were evaluated based on Common Terminology Criteria for Adverse Events version 4.0. RAI-associated nausea and vomiting of any grade were seen in 37.0 and 6.2 % of patients in total, respectively. Moderate to severe nausea (grade 2–3) was seen in 22.2 % of patients and associated with the dose of RAI per body weight (odds ratio = 1.046, p = 0.013), but not with the use of ramosetron, in multivariate logistic regression analysis. We have identified the dose of RAI per body weight to be an individual risk factor associated with moderate to severe RAI-associated nausea. This study failed to show that the combined use of ramosetron and domperidone reduced the frequency of RAI-associated nausea and vomiting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. D. Van Nostrand, The benefits and risks of I-131 therapy in patients with well-differentiated thyroid cancer. Thyroid 19, 1381–1391 (2009)

    Article  CAS  PubMed  Google Scholar 

  2. D. Van Nostrand, J. Neutze, F. Atkins, Side effects of “rational dose” iodine-131 therapy for metastatic well-differentiated thyroid carcinoma. J. Nucl. Med. 27, 1519–1527 (1986)

    PubMed  Google Scholar 

  3. S.L. Lee, Complications of radioactive iodine treatment of thyroid carcinoma. J. Natl. Compr. Cancer Netw. 8, 1277–1286 (2010). quiz 1287

    Google Scholar 

  4. M. Luster, S.E. Clarke, M. Dietlein, M. Lassmann, P. Lind, W.J. Oyen, J. Tennvall, E. Bombardieri, (EANM) EAoNM: Guidelines for radioiodine therapy of differentiated thyroid cancer. Eur. J. Nucl. Med. Mol. Imaging 35, 1941–1959 (2008)

    Article  CAS  PubMed  Google Scholar 

  5. C. Alexander, J.B. Bader, A. Schaefer, C. Finke, C.M. Kirsch, Intermediate and long-term side effects of high-dose radioiodine therapy for thyroid carcinoma. J. Nucl. Med. 39, 1551–1554 (1998)

    CAS  PubMed  Google Scholar 

  6. W.Y. Lin, Y.Y. Shen, S.J. Wang, Short-term hazards of low-dose radioiodine ablation therapy in postsurgical thyroid cancer patients. Clin. Nucl. Med. 21, 780–782 (1996)

    Article  CAS  PubMed  Google Scholar 

  7. P. Allweiss, G.D. Braunstein, A. Katz, A. Waxman, Sialadenitis following I-131 therapy for thyroid carcinoma: concise communication. J. Nucl. Med. 25, 755–758 (1984)

    CAS  PubMed  Google Scholar 

  8. R. Solans, J.A. Bosch, P. Galofré, F. Porta, J. Roselló, A. Selva-O’Callagan, M. Vilardell, Salivary and lacrimal gland dysfunction (sicca syndrome) after radioiodine therapy. J. Nucl. Med. 42, 738–743 (2001)

    CAS  PubMed  Google Scholar 

  9. R.T. Kloos, V. Duvuuri, S.M. Jhiang, K.V. Cahill, J.A. Foster, J.A. Burns, Nasolacrimal drainage system obstruction from radioactive iodine therapy for thyroid carcinoma. J. Clin. Endocrinol. Metab. 87, 5817–5820 (2002)

    Article  CAS  PubMed  Google Scholar 

  10. P. Feyer, M.H. Seegenschmiedt, M. Steingraeber, Granisetron in the control of radiotherapy-induced nausea and vomiting: a comparison with other antiemetic therapies. Support. Care Cancer 13, 671–678 (2005)

    Article  PubMed  Google Scholar 

  11. PCh. Feyer, E. Maranzano, A. Molassiotis, R.A. Clark-Snow, F. Roila, D. Warr, I. Olver, Radiotherapy-induced nausea and vomiting (RINV): antiemetic guidelines. Support. Care Cancer 13, 122–128 (2005)

    Article  PubMed  Google Scholar 

  12. P.C. Feyer, E. Maranzano, A. Molassiotis, F. Roila, R.A. Clark-Snow, K. Jordan, MASCC/ESMO: radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009. Support. Care Cancer 19(Suppl 1), S5–S14 (2011)

    Article  PubMed  Google Scholar 

  13. G.G. Abdelsayed, Management of radiation-induced nausea and vomiting. Exp. Hematol. 35, 34–36 (2007)

    Article  CAS  PubMed  Google Scholar 

  14. E. Basch, A.A. Prestrud, P.J. Hesketh, M.G. Kris, P.C. Feyer, M.R. Somerfield, M. Chesney, R.A. Clark-Snow, A.M. Flaherty, B. Freundlich, G. Morrow, K.V. Rao, R.N. Schwartz, G.H. Lyman, Oncology ASoC, Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J. Clin. Oncol. 29, 4189–4198 (2011)

    Article  PubMed  Google Scholar 

  15. T. Kita, K. Yokoyama, T. Higuchi, S. Kinuya, J. Taki, K. Nakajima, T. Michigishi, N. Tonami, Multifactorial analysis on the short-term side effects occurring within 96 hours after radioiodine-131 therapy for differentiated thyroid carcinoma. Ann. Nucl. Med. 18, 345–349 (2004)

    Article  PubMed  Google Scholar 

  16. A. De La Vieja, O. Dohan, O. Levy, N. Carrasco, Molecular analysis of the sodium/iodide symporter: impact on thyroid and extrathyroid pathophysiology. Physiol. Rev. 80, 1083–1105 (2000)

    Google Scholar 

  17. D.S. Cooper, G.M. Doherty, B.R. Haugen, B.R. Hauger, R.T. Kloos, S.L. Lee, S.J. Mandel, E.L. Mazzaferri, B. McIver, F. Pacini, M. Schlumberger, S.I. Sherman, D.L. Steward, R.M. Tuttle, Cancer ATAAGToTNaDT :Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19, 1167–1214 (2009)

    Article  PubMed  Google Scholar 

  18. E.B. Silberstein, A. Alavi, H.R. Balon, S.E. Clarke, C. Divgi, M.J. Gelfand, S.J. Goldsmith, H. Jadvar, C.S. Marcus, W.H. Martin, J.A. Parker, H.D. Royal, S.D. Sarkar, M. Stabin, A.D. Waxman, The SNMMI practice guideline for therapy of thyroid disease with 131I 3.0. J. Nucl. Med. 53, 1633–1651 (2012)

    Article  PubMed  Google Scholar 

  19. A.T. Monroe, S.C. Reddy, G.L. Gibbs, G.A. White, A.V. Peddada, Factors associated with radiation-induced nausea and vomiting in head and neck cancer patients treated with intensity modulated radiation therapy. Radiother. Oncol. 87, 188–194 (2008)

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan

    Toshiyuki Ikeoka, Takao Ando, Misa Imaizumi, Ikuko Ueki, Toshiro Usa & Atsushi Kawakami

Authors
  1. Toshiyuki Ikeoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takao Ando
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Misa Imaizumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ikuko Ueki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Toshiro Usa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Atsushi Kawakami
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takao Ando.

Additional information

Toshiro Usa and Atsushi Kawakami have contributed equally to the study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ikeoka, T., Ando, T., Imaizumi, M. et al. Moderate to severe nausea in radioactive iodine (RAI) therapy is associated with the RAI dose per body weight and was not prevented by ramosetron. Endocrine 46, 131–137 (2014). https://doi.org/10.1007/s12020-013-0054-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-013-0054-4

Keywords

Search

Navigation