Abstract
Objective
The aim of this study was to document the subjective and objective findings of symptomatic late-onset sialadenitis after radioiodine therapy in patients with differentiated thyroid cancer.
Methods
Subjective symptoms related to sialadenitis and Tc-99m pertechnetate salivary gland scintigram findings were assessed in 118 patients (26 males, 92 females) both before and during the late phase (mean 338 days) after the administration of radioiodine.
Results
Twelve of the 118 patients (10.2 %) complained of symptomatic sialadenitis in the late phase without symptoms during the early phase (within 7 days of radioiodine administration). Significant associations were found between subjective symptoms and visual scintigram findings during the late phase (p = 0.023). Furthermore, uptake and excretion by both parotid glands were significantly affected by radioiodine therapy.
Conclusions
Symptomatic late-onset sialadenitis occurred at an incidence of 10.2 %, and salivary gland function was affected in both parotids in most patients.
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References
Jhiang SM, Cho JY, Ryu KY, DeYoung BR, Smanik PA, McGaughy VR, et al. An immunohistochemical study of Na+/I− symporter in human thyroid tissues and salivary gland tissues. Endocrinology. 1998;139:4416–9.
Cavalieri RR. Iodine metabolism and thyroid physiology: current concepts. Thyroid. 1997;7:177–81.
Raza H, Khan AU, Hameed A, Khan A. Quantitative evaluation of salivary gland dysfunction after radioiodine therapy using salivary gland scintigraphy. Nucl Med Commun. 2006;27:495–9.
Allweiss P, Braunstein GD, Katz A, Waxman A. Sialadenitis following I-131 therapy for thyroid carcinoma: concise communication. J Nucl Med. 1984;25:755–8.
DiRusso G, Kern KA. Comparative analysis of complications from I-131 radioablation for well-differentiated thyroid cancer. Surgery. 1994;116:1024–30.
Malpani BL, Samuel AM, Ray S. Quantification of salivary gland function in thyroid cancer patients treated with radioiodine. Int J Radiat Oncol Biol Phys. 1996;35:535–40.
Alexander C, Bader JB, Schaefer A, Finke C, Kirsch CM. Intermediate and long-term side effects of high-dose radioiodine therapy for thyroid carcinoma. J Nucl Med. 1998;39:1551–4.
Bohuslavizki KH, Brenner W, Lassmann S, Tinnemeyer S, Tonshoff G, Sippel C, et al. Quantitative salivary gland scintigraphy in the diagnosis of parenchymal damage after treatment with radioiodine. Nucl Med Commun. 1996;17:681–6.
Almeida JP, Sanabria AE, Lima EN, Kowalski LP. Late side effects of radioactive iodine on salivary gland function in patients with thyroid cancer. Head Neck. 2011;33:686–90.
Helman J, Turner RJ, Fox PC, Baum BJ. 99mTc-pertechnetate uptake in parotid acinar cells by the Na+/K+/Cl− co-transport system. J Clin Invest. 1987;79:1310–3.
Newkirk KA, Ringel MD, Wartofsky L, Burman KD. The role of radioactive iodine in salivary gland dysfunction. Ear Nose Throat J. 2000;79:460–8.
Solans R, Bosch JA, Galofre P, Porta F, Rosello J, Selva-O’Callagan A, et al. Salivary and lacrimal gland dysfunction (sicca syndrome) after radioiodine therapy. J Nucl Med. 2001;42:738–43.
Mandel SJ, Mandel L. Radioactive iodine and the salivary glands. Thyroid. 2003;13:265–71.
Bohuslavizki KH, Brenner W, Lassmann S, Tinnemeyer S, Kalina S, Clausen M, et al. Quantitative salivary gland scintigraphy—a recommended examination prior to and after radioiodine therapy. Nuklearmedizin. 1997;36:103–9.
Levenson D, Gulec S, Sonenberg M, Lai E, Goldsmith SJ, Larson SM. Peripheral facial nerve palsy after high-dose radioiodine therapy in patients with papillary thyroid carcinoma. Ann Intern Med. 1994;120:576–8.
Klutmann S, Bohuslavizki KH, Kroger S, Bleckmann C, Brenner W, Mester J, et al. Quantitative salivary gland scintigraphy. J Nucl Med Technol. 1999;27:20–6.
Malpani BL, Samuel AM, Ray S. Differential kinetics of parotid and submandibular gland function as demonstrated by scintigraphic means and its possible implications. Nucl Med Commun. 1995;16:706–9.
Hazuka MB, Martel MK, Marsh L, Lichter AS, Wolf GT. Preservation of parotid function after external beam irradiation in head and neck cancer patients: a feasibility study using 3-dimensional treatment planning. Int J Radiat Oncol Biol Phys. 1993;27:731–7.
Stephens LC, Schultheiss TE, Price RE, Ang KK, Peters LJ. Radiation apoptosis of serous acinar cells of salivary and lacrimal glands. Cancer. 1991;67:1539–43.
Jentzen W, Schneider E, Freudenberg L, Eising EG, Gorges R, Muller SP, et al. Relationship between cumulative radiation dose and salivary gland uptake associated with radioiodine therapy of thyroid cancer. Nucl Med Commun. 2006;27:669–76.
Caglar M, Tuncel M, Alpar R. Scintigraphic evaluation of salivary gland dysfunction in patients with thyroid cancer after radioiodine treatment. Clin Nucl Med. 2002;27:767–71.
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An, YS., Yoon, JK., Lee, S.J. et al. Symptomatic late-onset sialadenitis after radioiodine therapy in thyroid cancer. Ann Nucl Med 27, 386–391 (2013). https://doi.org/10.1007/s12149-013-0697-5
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DOI: https://doi.org/10.1007/s12149-013-0697-5