Ovarian Function after Radioiodine Therapy in Patients with Thyroid Cancer

Abstract

Radioiodine causes transitory alterations in ovarian function even in younger women and after a mean activity of 4.2 GBq (115 mCi).

Preparation with Recombinant Human Thyroid-Stimulating Hormone for Thyroid Remnant Ablation with 131I Is Associated with Lowered Radiotoxicity

“…In contrast, not all investigators have confirmed the benefit of adjuvant therapy with 131 I in this group (2), with this therapy resulting in 2 relevant problems, the need for iatrogenic hypothyroidism (11) and radioiodine toxicity (1,(3)(4)(5)(6)(7)(8)(9)(10). With respect to the latter, a low activity (1.1-1.85 GBq ) is applied to minimize the adverse effects of radioiodine.…”

“…The lack of a significant and concomitant increase in pancreatic enzymes and the presence of symptoms of sialoadenitis, but not of pancreatitis, in patients with postradiation hyperamylasemia (31,32) confirm that the increase in amylase results from salivary gland injury. Administration of 3,700 MBq (100 mCi) has also resulted in an increase in FSH in all men 6 mo after therapy (7) but in only 28% of women (8). Regarding hematologic toxicity, Lima et al (33), using an activity of 9.25-13 GBq (250-350 mCi), observed mild or moderate thrombocytopenia and neutropenia on some occasions up to 60 d after therapy in 45% and 50% of patients, respectively.…”

“…Factors against routine postoperative ablation are the uncertainty regarding the benefit for low-risk patients (2) and the undesired effects of this procedure. Rapidly occurring (weeks) and intense (low thyroxine) hypothyroidism has been inevitable until recently for ablation with 131 I, and although well tolerated, adverse effects of radioiodine, such as damage to the salivary glands (3)(4)(5), impaired gonadal function (6)(7)(8)(9), oxidative injury (10), and even the risk of a secondary neoplasm (1), have been documented. The consequences of iatrogenic hypothyroidism (11) and adverse effects of 131 I may equal or even exceed the eventual benefits of ablation, particularly in lowrisk patients (1,2,12).…”

Malformations in the offspring of women with thyroid cancer treated with radioiodine for the ablation of thyroid remnants

“…Ovarian function is only temporarily compromised by radioiodine (2)(3)(4)(5), with permanent infertility being rare (2). Thus, many women with thyroid cancer treated with radioiodine may become pregnant, and it is therefore important to evaluate the evolution of these pregnancies and the consequences for the offspring.…”

Nódulos de tireóide e câncer diferenciado de tireóide: consenso brasileiro

“…Por outro lado, o radioiodo tem sido associado a complicações como alterações transitórias da função gonadal (85,86), menopausa precoce (87), dano permanente às glân-dulas salivares e conjuntivite recorrente (88), além do risco potencial de um novo câncer (89). Todos estes aspectos devem ser considerados na definição da terapia adjuvante com 131 I após a cirurgia.…”