Correlation among ocular surface disease, xerostomia, and nasal symptoms in patients with differentiated thyroid carcinoma subjected to radioiodine therapy: A prospective comparative study

Fonseca, Fabricio Lopes da; Yamanaka, Patricia Kazue; Mazoti, Luciana; Arakawa-Sugueno, Lica; Kato, Juliana Mika; Matayoshi, Suzana

doi:10.1002/hed.24895

Cited by 11 publications

(19 citation statements)

References 59 publications

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“…There is a small body of literature evaluating the effect of RAI treatment on lacrimal gland function, manifesting typically as eye dryness, pruritus and other secondary ocular surface abnormalities. Often patients with ocular symptoms demonstrate minimal or no objective findings that correlate with their disease 22‐25 . Fortunately, in most patients, these ophthalmic symptoms tend to decrease over the first 3 years after treatment 25…”

Section: Pathophysiologymentioning

confidence: 99%

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Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology

et al. 2020

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Background: Postoperative radioactive iodine (RAI) administration is widely utilized in patients with differentiated thyroid cancer. While beneficial in select patients, it is critical to recognize the potential negative sequelae of this treatment. The prevention, diagnosis, and management of the salivary and lacrimal complications of RAI exposure are addressed in this consensus statement. Methods: A multidisciplinary panel of experts was convened under the auspices of the American Head and Neck Society Endocrine Surgery and Salivary Gland Sections. Following a comprehensive literature review to assess the current best evidence, this group developed six relevant consensus recommendations. Results: Consensus recommendations on RAI were made in the areas of patient assessment, optimal utilization, complication prevention, and complication management. Conclusion: Salivary and lacrimal complications secondary to RAI exposure are common and need to be weighed when considering its use. The recommendations included in this statement provide direction for approaches to minimize and manage these complications.

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Section: Pathophysiologymentioning

confidence: 99%

“…Three months after RAI treatment, approximately 10% of patients complain of nasal symptoms 27 . While cells within the nasolacrimal ducts express the sodium iodine symporter, nasal tissues do not 24,28‐30 . Thus, the mechanism of nasal‐induced RAI symptoms is still not entirely understood.…”

Section: Pathophysiologymentioning

confidence: 99%

Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology

et al. 2020

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“…Iodine‐131 (I 131 ) therapy is associated with a high prevalence of side effects, especially salivary and lacrimal gland dysfunction (Sicca syndrome), nasal dryness, gustatory dysfunction, and dysphagia 3‐9 …”

Section: Introductionmentioning

confidence: 99%

Salivary side effects after radioiodine treatment for differentiated papillary thyroid carcinoma: Long‐term study

et al. 2020

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Background: Although many studies focus on short-term side effects of radioiodine therapy, almost none studied long-term side effects. We assessed radioiodine long-term salivary side effects after radioiodine treatment for differentiated papillary thyroid carcinoma and compared it to short-term morbidity within the same population. Methods: A standardized self-administrated questionnaire was submitted in 2019 by patients treated with radioiodine between January 2011 and December 2012. These patients had already answered the same questionnaire 6 years before. Results: Our study showed a significant reduction for salivary side effects: discomfort in submandibular or parotid area, swelling, pain, a bad or salty taste in the mouth, allowing to get back to a "normal" diet. Conclusions: Our study suggests that a significant rate of patients will recover from I 131 therapy salivary side effects. As almost 30% of these remissions happened during our late stage follow-up, we highlight the necessity of a longterm follow-up in these patients.

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“…Клиническим проявлением поражения слезных желез и нарушения слезопродукции является развитие сухого кератоконъюнктивита. Стоит отметить, что почти в четверти наблюдаемых случаев изменения имеют транзиторный характер и не требуют какой-либо специальной коррекции [ 11 ][ 20 ][ 21 ]. Авторы, проводившие исследования, которые касались патоморфологических изменений слезной железы после воздействия 131I, пришли к заключению, что в основе механизма поражения лежит оксидативный стресс, индуцированный ионизирующим излучением [ 22 ].…”

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The lacrimal apparatus as an organ at risk during radionuclide therapy

Sheremeta,

Trukhin,

Yartsev

et al. 2024

Probl Endokrinol (Mosk)

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Within the framework of the article, the authors analyzed the available information about the damage to the lacrimal apparatus during radionuclide therapy. In focus of article lesions of the lacrimal production system, the main and accessory lacrimal glands, as well as lacrimal drainage are considered. It was found that damage to the lacrimal apparatus is characteristic of 131I therapy for thyroid cancer, as well as for radioligand therapy using anti-PSMA antibodies labeled with 177Lu and 225Ac. 177Lu-PSMA and 225Ac-PSMA may damage the lacrimal gland with the formation of a clinically pronounced "dry eye syndrome". The pathogenesis of such lesions is associated with the accumulation of a radioisotope in the tissues of the lacrimal apparatus, while during therapy with 131I, accumulation is realized due to the expression of the sodium-iodine symporter in the nasolacrimal duct, and during therapy with 177Lu-PSMA and 225Ac-PSMA, the radiobiological effect is realized in connection with the expression PSMA by lacrimal tissue. An analysis of the available sources showed that to date there are no results of systematic studies on the problem, there is a lack of knowledge regarding the individual risks of developing these complications, methods for their prevention that have proven effectiveness have not been developed, and the treatment methods used, having relatively low efficiency, are not specialized. The authors concluded that the strengthening of interdisciplinary interaction, as well as the organization verification methodology and correct studies, can contribute to solving problems related to the study of the complications under consideration.

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Correlation among ocular surface disease, xerostomia, and nasal symptoms in patients with differentiated thyroid carcinoma subjected to radioiodine therapy: A prospective comparative study

Abstract: Subjective worsening of xerostomia, xerophthalmia, nasal symptoms, and changes in the nasal mucosa in group 1 was observed.

Cited by 11 publications

References 59 publications

Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology

Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology

Salivary side effects after radioiodine treatment for differentiated papillary thyroid carcinoma: Long‐term study

The lacrimal apparatus as an organ at risk during radionuclide therapy

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