Incidence and risk factors for radioactive iodine-induced sialadenitis

Barrueco, Álvaro Sánchez; Galán, Fernando González; Rueda, Ignacio Alcalá; Coello, Jessica Mireya Santillán; Dorado, María Pilar Barrio; Aubá, José Miguel Villacampa; Escanciano, Manuel Escanciano; Jiménez, Lucía Llanos; Mahíllo‐Fernández, Ignacio; Español, Carlos Cenjor

doi:10.1080/00016489.2020.1802507

Cited by 13 publications

(8 citation statements)

References 14 publications

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“…As they contain more serous cells, parotid glands (PGs) are affected more often than submandibular glands (SMGs) [5,12,13]. The effects of RAI treatment on salivary glands were assessed by imaging using scintigraphy [2,4,14,15,16,17] or ultrasound (US) [8,18,19,20,21,22]. RAIS was characterized by changes to the echo-structure of glands on US [8,18,19,20,21,22].…”

Section: Materials Und Methoden Retrospektive Analyse Von Us-mentioning

confidence: 99%

“…Data regarding RAIS were published after treatment of DTC, but not after treatment of BTD. A possible dose dependence of the effects of RAIT on the major salivary glands was investigated in several publications using scintigraphy-based [2,14,15,16,17] or US-based methods [8,18,19,20,21,22]. The data indicated that the risk of RAIS increased with higher doses.…”

Section: Materials Und Methoden Retrospektive Analyse Von Us-mentioning

confidence: 99%

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Ultrasound Changes in Salivary Glands after Radioactive Iodine Treatment in Benign Diseases and Differentiated Cancer of Thyroid Glands in Consideration of Dose and Time Dependency

Koch,

Fauck,

Sievert

et al. 2024

Ultraschall Med

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Purpose To assess ultrasound (US) features observed in salivary glands after radioactive iodine treatment (RAIT) in relation to the dose and time interval after RAIT. Materials and Methods A retrospective analysis of US findings regarding the salivary glands of patients presenting after RAIT due to thyroid cancer (Group 1, n=99) or benign thyroid diseases (Group 2, n=25). The control group consisted of randomly selected patients (no RAIT, Group 3, n=100). Groups were compared regarding RAIT dose, symptoms, and US findings (duct dilation, hypoechoic/heterogeneous parenchyma, parenchymal loss). The association of the presence of US parameters after RAIT with various dose levels (2000–15000MBq) and time intervals (24, 60, 120 months) and the differences between the groups was evaluated. Results Significant differences between US parameters were noted when comparing Group 1 with Group 2 or 3. Nothing of relevant significance was noted when Groups 2 and 3 were compared. US features indicating a slight or moderate sialadenitis showed the most significant associations with doses <4000MBq and time intervals <24 months after RAIT. US changes indicating a serious sialadenitis or even gland atrophy showed the most significant association at doses between >7000–9000MBq and when US was performed >60 months after RAIT. Conclusion Our results point to a dose and time dependency of pathologic US findings in RAIT-induced effects on the major salivary glands. Based on the US findings, a better estimation of the current impact of RAIT on the salivary glands and the further prognosis appears possible.

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Section: Materials Und Methoden Retrospektive Analyse Von Us-mentioning

confidence: 99%

Section: Materials Und Methoden Retrospektive Analyse Von Us-mentioning

confidence: 99%

Ultrasound Changes in Salivary Glands after Radioactive Iodine Treatment in Benign Diseases and Differentiated Cancer of Thyroid Glands in Consideration of Dose and Time Dependency

Koch,

Fauck,

Sievert

et al. 2024

Ultraschall Med

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“…However, a more recent paper by Barrueco et al. found that RAI-induced sialadenitis frequently involved unilaterally and occurred equally in both parotid and submandibular glands ( 8 ). The sialadenitis begins within 24-48 hours and persists for a few days ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

“…Incidence of acute sialadenitis varies with a range of 2-67% ( 10 ) and that of chronic sialadenitis ranges from 11 to 43% ( 4 ). The higher cumulative dose of radioiodine in the salivary gland is associated with an increased risk of salivary gland damage ( 6 – 8 , 11 ). These adverse effects have a great impact on patients’ quality of life.…”

Section: Introductionmentioning

confidence: 99%

“…This is because the parotid gland has a higher proportion of serous cells that are more sensitive to I-131 than the submandibular gland that has a higher proportion of mucous acini (4,6,7). However, a more recent paper by Barrueco et al found that RAI-induced sialadenitis frequently involved unilaterally and occurred equally in both parotid and submandibular glands (8). The sialadenitis begins within 24-48 hours and persists for a few days (9).…”

Section: Introductionmentioning

confidence: 99%

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Prevention of salivary gland dysfunction in patients treated with radioiodine for differentiated thyroid cancer: A systematic review of randomized controlled trials

et al. 2022

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IntroductionSalivary gland dysfunction (e.g., sialadenitis and xerostomia) is the most common complication of radioactive iodine (RAI) therapy for differentiated thyroid cancer (DTC). Several methods have been used to reduce/prevent this adverse effect. We aimed to systematically review the effectiveness of non-pharmacological and pharmacological interventions in preventing RAI-induced salivary gland dysfunction in patients with DTC.MethodsA systematic review was conducted, according to PRISMA guidelines. The protocol was registered (PROSPERO: CRD42022295229). PubMed, Embase, Scopus, and the Cochrane Library electronic databases were searched from inception to November 2021. Inclusion criteria were randomized controlled trials of DTC patients who were older than 18 years and underwent RAI after thyroidectomy in which at least one studied group received an intervention to prevent salivary gland dysfunction.ResultsTwelve studies (a total of 667 participants) were included. Among DTC patients who were treated with RAI, nonpharmacological treatment such as parotid gland massage and aromatherapy ameliorated salivary gland dysfunction. Antioxidants such as vitamin E and selenium demonstrated radioprotective effects on the salivary gland, while other antioxidants did not show radioprotective benefits. Vitamin C showed no significant effects on preventing salivary gland dysfunction. Amifostine had inconsistent outcomes among studies. Among cholinergic agonists, pilocarpine did not demonstrate the radioprotective effect on parotid glands, while bethanechol lowered salivary gland dysfunction. However, the negative results from pilocarpine may be explained by the strong sialorrheic effect of the Cincinnati regimen in both study arms.ConclusionAmong non-pharmacological and pharmacological methods, parotid gland massage, aromatherapy, vitamin E, selenium, amifostine, and bethanechol may have benefits in minimizing RAI-induced salivary gland dysfunction in patients with DTC. The results are limited by a small number of patients and should be confirmed in future larger randomized controlled trials.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295229, PROSPERO, identifier CRD42022295229.

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Diagnosis and Treatment of Radioactive Iodine‐Induced Sialadenitis: A 10‐Year Endoscopic Experience

Li,

Yang,

et al. 2024

The Laryngoscope

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ObjectivesThe aim of this study was to explore the endoscopic characteristics of radioactive iodine‐induced sialadenitis (RAIS), and to evaluate the treatment outcomes of endoscopic intervention for RAIS.Study DesignRetrospective case series.MethodsEighty‐two consecutive patients (11 males and 71 females) diagnosed as RAIS from Nov. 2012 to Sep. 2023 were retrospectively included. All patients underwent endoscopic exploration and intervention of the affected glands. The endoscopic features were collected, and treatment outcomes were followed‐up and evaluated through post to pre‐operative comparisons of gland status.ResultsOverall, endoscopic procedures were undertaken for 162 parotid glands (PGs) and 62 submandibular glands (SMGs). Endoscopy showed severe lumen stricture (49.3%) and ductal atresia (23.5%) in PGs, as well as severe stenosis of the anterior duct and ectasia of the proximal duct (59.7%) in SMGs. During a median six months' follow‐up, the treatment outcomes of PGs were evaluated as “improvement” in 23.4%，“lesion maintenance” in 45.1% and “lesion aggravation” in 31.5% of the glands. As for SMGs, the treatment outcomes were scored as “improvement”in 29.0%，“lesion maintenance”in 54.8%, and“lesion aggravation”in 16.1% of the glands. No significant differences of treatment outcomes were found relative to RAI treatment sessions and cumulative dosage.ConclusionRAIS is characteristic of severe lumen stricture and ductal atresia in PGs, and stenosis of the distal duct and ectasia of the proximal duct in SMGs. Endoscopy can alleviate clinical symptoms of RAIS and help to preserve the gland function.Level of Evidence4 Laryngoscope, 2024

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Incidence and risk factors for radioactive iodine-induced sialadenitis

Cited by 13 publications

References 14 publications

Ultrasound Changes in Salivary Glands after Radioactive Iodine Treatment in Benign Diseases and Differentiated Cancer of Thyroid Glands in Consideration of Dose and Time Dependency

Ultrasound Changes in Salivary Glands after Radioactive Iodine Treatment in Benign Diseases and Differentiated Cancer of Thyroid Glands in Consideration of Dose and Time Dependency

Prevention of salivary gland dysfunction in patients treated with radioiodine for differentiated thyroid cancer: A systematic review of randomized controlled trials

Diagnosis and Treatment of Radioactive Iodine‐Induced Sialadenitis: A 10‐Year Endoscopic Experience

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