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The effects of radioiodine therapy on parathyroid function among patients with papillary thyroid cancer: a retrospective cohort study

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Abstract

Purpose

To explore the effects of initial radioiodine therapy on parathyroid function among postoperative papillary thyroid cancer (PTC) patients.

Methods

Postoperative PTC patients who were admitted in our department from April 2018 to April 2019 were recruited. Patients were divided into two groups: Group A, who underwent surgery and initial radioiodine therapy in our hospital, and Group B, who did not receive radioiodine therapy after surgery. The levels of serum calcium, magnesium, phosphorus, parathyroid hormone (PTH), and 25 hydroxyvitamin D3 were collected. Data were analyzed by SPSS 25.0.

Results

A total of 252 patients were included. Between the two groups, no significant difference of PTH in 6th, 9th, and 12th month was found during postoperative follow-up (p = 0.493, p = 0.202, p = 0.814). No significant difference of PTH was found after stratifying Group A according to 131I dosage (p = 0.751 for 6th month after operation, p = 0.130 for 9th month after operation, p = 0.683 for 12th month after operation), interval time between surgery and radioiodine therapy (p = 0.522 for 3rd day after 131I therapy, p = 0.184 for 9th month after operation, p = 0.311 for 12th month after operation), and ratio of parathyroid autotransplantation (p = 0.545 for 3rd day after 131I therapy, p = 0.485 for 6th month after operation, p = 0.201 for 9th month after operation, p = 0.146 for 12th month after operation).

Conclusions

Initial radioiodine therapy following PTC surgery had no significant adverse effect on parathyroid function in the short term. However, physicians should inform patients of possible risks of abnormal parathyroid function prior to RAI therapy, and parathyroid function was periodically reviewed after RAI therapy.

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Data availability

All data were collected retrospectively from clinical database of our center. We declare the authenticity and transparency of the data.

Code availability

All statistical analyses were performed using IBM SPSS Statistics version 25.0 for Windows (IBM Corp., Armonk, NY).

References

  1. B.R. Roman, L.G. Morris, L. Davies, The thyroid cancer epidemic, 2017 perspective. Curr. Opin. Endocrinol. Diabetes Obes. 24, 332–336 (2017)

    Article  Google Scholar 

  2. F. Galuppini, G. Pennelli, M: Rugge, The rising incidence of papillary thyroid cancer: more cancers or more assessments? Indian J. Cancer 56, 183–184 (2019)

    Article  Google Scholar 

  3. B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid 26, 1–133 (2016)

    Article  Google Scholar 

  4. C.C. Lubitz, J.A. Sosa, The changing landscape of papillary thyroid cancer: epidemiology, management, and the implications for patients. Cancer 122, 3754–3759 (2016)

    Article  Google Scholar 

  5. B.E. Hertz, K.E. Schuller, Saul Hertz.: MD (1905-1950): a pioneer in the use of radioactive iodine. Endocr. Pract. 16, 713–715 (2010)

    Article  Google Scholar 

  6. M. Schmidt, R. Görges, A. Drzezga, M. Dietlein, A matter of controversy: is radioiodine therapy favorable in differentiated thyroid carcinoma? J. Nucl. Med. 59, 1195–1201 (2018)

    Article  CAS  Google Scholar 

  7. A. Fard-Esfahani, A. Emami-Ardekani, B. Fallahi, P. Fard-Esfahani, D. Beiki, Adverse effects of radioactive iodine-131 treatment for differentiated thyroid carcinoma. Nucl. Med. Commun. 35, 808–817 (2014)

    Article  CAS  Google Scholar 

  8. D. Albano, F. Bertagna, M.B. Panarotto, R. Giubbini, Early and late adverse effects of radioiodine for pediatric differentiated thyroid cancer. Pediatr. Blood Cancer 64, 1–7 (2017)

  9. E.E. Pochin, Leukaemia following radioiodine treatment of thyrotoxicosis. Br. Med. J. 2, 1545–1550 (1960)

    Article  CAS  Google Scholar 

  10. M. Mannstadt, J.P. Bilezikian, R.V. Thakker, F.M. Hannan, B.L. Clarke, Hypoparathyroidism. Nat. Rev. 3, 17055 (2017)

    Google Scholar 

  11. Hadiza S. Kazaure, Alan Zambeli-Ljepovic, Taofik Oyekunle, Sanziana A. Roman, Julie A. Sosa, Severe hypocalcemia after thyroidectomy: an analysis of 7366 patients. Ann. Surg. 1–3 (2019)

  12. A. Guven, S. Salman, H. Boztepe, S. Yarman, R: Tanakol, Parathyroid changes after high dose radioactive iodine in patients with thyroid cancer. Ann. Nucl. Med. 23, 437–441 (2009)

    Article  CAS  Google Scholar 

  13. G.A. Glazebrook, Effect of decicurie doses of radioactive iodine 131 on parathyroid function. Am. J. Surg. 154, 368–373 (1987)

    Article  CAS  Google Scholar 

  14. Z.H. Zhao, F.Q. Li, J.K. Han, X.J. Li, Effect of 131I ‘clear residual thyroid tissue’ after surgery on the function of parathyroid gland in differentiated thyroid cancer. Exp. Ther. Med. 10, 2079–2082 (2015)

    Article  CAS  Google Scholar 

  15. A. Zhang, P. Li, Q. Liu, S. Peng, G. Huang, effect of post-surgical RAI therapy on parathyroid function in patients with differentiated thyroid cancer. Endocr. Pract. 26(4), 416–422 (2020)

    Article  Google Scholar 

  16. A.G. Bondeson, L. Bondeson, N.W. Thompson, Hyperparathyroidism after treatment with radioactive iodine: not only a coincidence? Surgery 106(6), 1025–1027 (1989)

    CAS  PubMed  Google Scholar 

  17. D.L. Gomez, D.I. Shulman, Hyperparathyroidism two years after radioactive iodine therapy in an adolescent male. Case Rep. Pediatr. 1–3 (2014)

  18. J.G. Cundiff, L. Portugal, H. David, Sarne Parathyroid adenoma after radioactive iodine therapy for multinodular goiter. Am. J. Otolaryngol. 22, 374–375 (2001)

    Article  CAS  Google Scholar 

  19. T. Rasmuson, B. Tavelin, Risk of parathyroid adenomas in patients with thyrotoxicosis exposed to radioactive iodine. Acta Oncol. 45, 1059–1061 (2006)

    Article  CAS  Google Scholar 

  20. P. Szumowski, S. Abdelrazek, M. Mojsak, F. Rogowski, A. Kociura-Sawicka, Parathyroid gland function after radioiodine ((131)I) therapy for toxic and non-toxic goitre. Endokrynol. Pol. 64, 340–345 (2013)

    Article  CAS  Google Scholar 

  21. T. Petrich, W.H. Knapp, E: Pötter, Functional activity of human sodium/iodide symporter in tumor cell lines. Exp Ther. Med. 42, 15–18 (2003)

    CAS  Google Scholar 

  22. A. Altorjay, O. Dohán, A. Szilágyi, M. Paroder, I.L. Wapnir, Expression of the Na+/I− symporter (NIS) is markedly decreased or absent in gastric cancer and intestinal metaplastic mucosa of Barrett esophagus. BMC Cancer 7, (2007)

  23. K.M. La Perle, D.C. Kim, N.C. Hall, A. Bobbey, D.H. Shen, Modulation of sodium/iodide symporter expression in the salivary gland. Thyroid 23, 1029–1036 (2013)

    Article  CAS  Google Scholar 

  24. T. Saito, T. Endo, A. Kawaguchi, M. Ikeda, R. Katoh, Increased expression of the sodium/iodide symporter in papillary thyroid carcinomas. J. Clin. Investig. 101, 1296–1300 (1998)

    Article  CAS  Google Scholar 

  25. H.L. Kaplan, H.C. Allen, D.B. Butler, Thyroid carcinoma with extensive pulmonary metastases treated with radioiodine: report of a case. Am. Pract. Dig. Treat. 12, 31–40 (1961)

    CAS  PubMed  Google Scholar 

  26. A. Shieh, C. Ma, R.F. Chun, J. Wittwer-Schegg, L. Swinkels, T. Huijs,, Associations between change in total and free 25-hydroxyvitamin D With 24,25-dihydroxyvitamin D and parathyroid hormone. J. Clin. Endocrinol. Metab 103(9), 3368–3375 (2018).

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, NO. 37 Guo Xue Xiang, 610041, Chengdu, Sichuan, PR China

    Yuan Fei, Yuxuan Qiu, Zhichao Xing, Wanjun Zhao, Anping Su & Jingqiang Zhu

Authors
  1. Yuan Fei
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  2. Yuxuan Qiu
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  3. Zhichao Xing
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  4. Wanjun Zhao
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  5. Anping Su
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  6. Jingqiang Zhu
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Contributions

Study conception and design: Y.F., J.Z., and A.S.; acquisition of data: Y.F. and Y.Q. Analysis and interpretation of data: Y.F. and Z.X.; drafting of manuscript: Y.F., Y.Q., Z.X., W.Z. Critical revision of manuscript: J.Z., and A.S.

Corresponding authors

Correspondence to Anping Su or Jingqiang Zhu.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

Ethical approval was waived by the local Ethics Committee of Sichuan University in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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We obtained consent from participants to participate in the study and to publish their data. All authors have read and approved the manuscript.

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Fei, Y., Qiu, Y., Xing, Z. et al. The effects of radioiodine therapy on parathyroid function among patients with papillary thyroid cancer: a retrospective cohort study. Endocrine 70, 426–434 (2020). https://doi.org/10.1007/s12020-020-02429-8

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  • DOI: https://doi.org/10.1007/s12020-020-02429-8

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