Long-term effects of radioiodine treatment on salivary gland function in adult survivors of pediatric differentiated thyroid carcinoma

Tharsana Selvakumar, Marloes Nies, Mariëlle S. Klein Hesselink, Adrienne H. Brouwers, Anouk N.A. Van Der Horst-Schrivers, Esther N. Klein Hesselink, Wim J.E. Tissing, Arjan Vissink, Thera P. Links, Dutch Pediatric Thyroid Cancer Study Consortium

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Pediatric differentiated thyroid cancer (DTC) is a rare disease. Initial treatment of DTC consists of a total or near-total thyroidectomy and 131 I therapy. Previous studies on adults showed that 131 I treatment may reduce salivary gland function (SGF). Studies regarding SGF in children treated for DTC are sparse. Our aim was to assess the long-term effects of 131 I treatment on SGF in survivors of pediatric DTC. Methods: In a nationwide cross-sectional study, SGF in patients treated for pediatric DTC between 1970 and 2013 (.5 y after diagnosis, $18 y old at the time of evaluation) was studied. SGF was assessed by sialometry, sialochemistry, and a xerostomia inventory. Salivary gland dysfunction (SGD) was defined as an unstimulated whole saliva flow of no more than 0.2 mL/min or a stimulated whole saliva flow of no more than 0.7 mL/min. Results: Sixty-five patients underwent 131 I treatment (median age at evaluation, 33 y, with an interquartile range [IQR] of 25–40 y; 86.2% female; median follow-up period, 11 y, with an IQR of 6–22 y). Median cumulative 131 I activity was 5.88 GBq, with an IQR of 2.92–12.95 GBq, and 47.7% underwent multiple 131 I administrations. SGD was present in 30 (47.6%) patients. Levels of amylase and total protein in saliva were reduced. Moderate to severe xerostomia was present in 22 (35.5%) patients. Stimulated salivary secretion was lower and the severity of xerostomia complaints higher in patients treated with higher cumulative 131 I activity. Conclusion: In survivors of pediatric DTC, clinically significant SGD was found in 35.5% and was related to the cumulative 131 I activity of the treatment.

Original languageEnglish
Pages (from-to)172-177
Number of pages6
JournalJournal of Nuclear Medicine
Volume60
Issue number2
DOIs
Publication statusPublished - 1 Feb 2019

Cite this

Selvakumar, T., Nies, M., Klein Hesselink, M. S., Brouwers, A. H., Van Der Horst-Schrivers, A. N. A., Klein Hesselink, E. N., ... Dutch Pediatric Thyroid Cancer Study Consortium (2019). Long-term effects of radioiodine treatment on salivary gland function in adult survivors of pediatric differentiated thyroid carcinoma. Journal of Nuclear Medicine, 60(2), 172-177. https://doi.org/10.2967/jnumed.118.212449
Selvakumar, Tharsana ; Nies, Marloes ; Klein Hesselink, Mariëlle S. ; Brouwers, Adrienne H. ; Van Der Horst-Schrivers, Anouk N.A. ; Klein Hesselink, Esther N. ; Tissing, Wim J.E. ; Vissink, Arjan ; Links, Thera P. ; Dutch Pediatric Thyroid Cancer Study Consortium. / Long-term effects of radioiodine treatment on salivary gland function in adult survivors of pediatric differentiated thyroid carcinoma. In: Journal of Nuclear Medicine. 2019 ; Vol. 60, No. 2. pp. 172-177.
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title = "Long-term effects of radioiodine treatment on salivary gland function in adult survivors of pediatric differentiated thyroid carcinoma",
abstract = "Pediatric differentiated thyroid cancer (DTC) is a rare disease. Initial treatment of DTC consists of a total or near-total thyroidectomy and 131 I therapy. Previous studies on adults showed that 131 I treatment may reduce salivary gland function (SGF). Studies regarding SGF in children treated for DTC are sparse. Our aim was to assess the long-term effects of 131 I treatment on SGF in survivors of pediatric DTC. Methods: In a nationwide cross-sectional study, SGF in patients treated for pediatric DTC between 1970 and 2013 (.5 y after diagnosis, $18 y old at the time of evaluation) was studied. SGF was assessed by sialometry, sialochemistry, and a xerostomia inventory. Salivary gland dysfunction (SGD) was defined as an unstimulated whole saliva flow of no more than 0.2 mL/min or a stimulated whole saliva flow of no more than 0.7 mL/min. Results: Sixty-five patients underwent 131 I treatment (median age at evaluation, 33 y, with an interquartile range [IQR] of 25–40 y; 86.2{\%} female; median follow-up period, 11 y, with an IQR of 6–22 y). Median cumulative 131 I activity was 5.88 GBq, with an IQR of 2.92–12.95 GBq, and 47.7{\%} underwent multiple 131 I administrations. SGD was present in 30 (47.6{\%}) patients. Levels of amylase and total protein in saliva were reduced. Moderate to severe xerostomia was present in 22 (35.5{\%}) patients. Stimulated salivary secretion was lower and the severity of xerostomia complaints higher in patients treated with higher cumulative 131 I activity. Conclusion: In survivors of pediatric DTC, clinically significant SGD was found in 35.5{\%} and was related to the cumulative 131 I activity of the treatment.",
keywords = "Pediatric differentiated thyroid carcinoma, Radioiodine treatment, Salivary gland dysfunction, Xerostomia",
author = "Tharsana Selvakumar and Marloes Nies and {Klein Hesselink}, {Mari{\"e}lle S.} and Brouwers, {Adrienne H.} and {Van Der Horst-Schrivers}, {Anouk N.A.} and {Klein Hesselink}, {Esther N.} and Tissing, {Wim J.E.} and Arjan Vissink and Links, {Thera P.} and Gianni Bocca and Burgerhof, {Johannes G.M.} and {Van Dam}, {Eveline W.C.M.} and Bas Havekes and {Van Den Heuvel-Eibrink}, {Marry M.} and Corssmit, {Eleonora P.M.} and Kremer, {Leontine C.M.} and Netea-Maier, {Romana T.} and {Van Der Pal}, {Heleen J.H.} and Peeters, {Robin P.} and Smit, {Johannes W.A.} and Plukker, {John T.M.} and Ronckers, {Cecile M.} and {Van Santen}, {Hanneke M.} and {Dutch Pediatric Thyroid Cancer Study Consortium}",
year = "2019",
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language = "English",
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Selvakumar, T, Nies, M, Klein Hesselink, MS, Brouwers, AH, Van Der Horst-Schrivers, ANA, Klein Hesselink, EN, Tissing, WJE, Vissink, A, Links, TP & Dutch Pediatric Thyroid Cancer Study Consortium 2019, 'Long-term effects of radioiodine treatment on salivary gland function in adult survivors of pediatric differentiated thyroid carcinoma' Journal of Nuclear Medicine, vol. 60, no. 2, pp. 172-177. https://doi.org/10.2967/jnumed.118.212449

Long-term effects of radioiodine treatment on salivary gland function in adult survivors of pediatric differentiated thyroid carcinoma. / Selvakumar, Tharsana; Nies, Marloes; Klein Hesselink, Mariëlle S.; Brouwers, Adrienne H.; Van Der Horst-Schrivers, Anouk N.A.; Klein Hesselink, Esther N.; Tissing, Wim J.E.; Vissink, Arjan; Links, Thera P.; Dutch Pediatric Thyroid Cancer Study Consortium.

In: Journal of Nuclear Medicine, Vol. 60, No. 2, 01.02.2019, p. 172-177.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Long-term effects of radioiodine treatment on salivary gland function in adult survivors of pediatric differentiated thyroid carcinoma

AU - Selvakumar, Tharsana

AU - Nies, Marloes

AU - Klein Hesselink, Mariëlle S.

AU - Brouwers, Adrienne H.

AU - Van Der Horst-Schrivers, Anouk N.A.

AU - Klein Hesselink, Esther N.

AU - Tissing, Wim J.E.

AU - Vissink, Arjan

AU - Links, Thera P.

AU - Bocca, Gianni

AU - Burgerhof, Johannes G.M.

AU - Van Dam, Eveline W.C.M.

AU - Havekes, Bas

AU - Van Den Heuvel-Eibrink, Marry M.

AU - Corssmit, Eleonora P.M.

AU - Kremer, Leontine C.M.

AU - Netea-Maier, Romana T.

AU - Van Der Pal, Heleen J.H.

AU - Peeters, Robin P.

AU - Smit, Johannes W.A.

AU - Plukker, John T.M.

AU - Ronckers, Cecile M.

AU - Van Santen, Hanneke M.

AU - Dutch Pediatric Thyroid Cancer Study Consortium

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Pediatric differentiated thyroid cancer (DTC) is a rare disease. Initial treatment of DTC consists of a total or near-total thyroidectomy and 131 I therapy. Previous studies on adults showed that 131 I treatment may reduce salivary gland function (SGF). Studies regarding SGF in children treated for DTC are sparse. Our aim was to assess the long-term effects of 131 I treatment on SGF in survivors of pediatric DTC. Methods: In a nationwide cross-sectional study, SGF in patients treated for pediatric DTC between 1970 and 2013 (.5 y after diagnosis, $18 y old at the time of evaluation) was studied. SGF was assessed by sialometry, sialochemistry, and a xerostomia inventory. Salivary gland dysfunction (SGD) was defined as an unstimulated whole saliva flow of no more than 0.2 mL/min or a stimulated whole saliva flow of no more than 0.7 mL/min. Results: Sixty-five patients underwent 131 I treatment (median age at evaluation, 33 y, with an interquartile range [IQR] of 25–40 y; 86.2% female; median follow-up period, 11 y, with an IQR of 6–22 y). Median cumulative 131 I activity was 5.88 GBq, with an IQR of 2.92–12.95 GBq, and 47.7% underwent multiple 131 I administrations. SGD was present in 30 (47.6%) patients. Levels of amylase and total protein in saliva were reduced. Moderate to severe xerostomia was present in 22 (35.5%) patients. Stimulated salivary secretion was lower and the severity of xerostomia complaints higher in patients treated with higher cumulative 131 I activity. Conclusion: In survivors of pediatric DTC, clinically significant SGD was found in 35.5% and was related to the cumulative 131 I activity of the treatment.

AB - Pediatric differentiated thyroid cancer (DTC) is a rare disease. Initial treatment of DTC consists of a total or near-total thyroidectomy and 131 I therapy. Previous studies on adults showed that 131 I treatment may reduce salivary gland function (SGF). Studies regarding SGF in children treated for DTC are sparse. Our aim was to assess the long-term effects of 131 I treatment on SGF in survivors of pediatric DTC. Methods: In a nationwide cross-sectional study, SGF in patients treated for pediatric DTC between 1970 and 2013 (.5 y after diagnosis, $18 y old at the time of evaluation) was studied. SGF was assessed by sialometry, sialochemistry, and a xerostomia inventory. Salivary gland dysfunction (SGD) was defined as an unstimulated whole saliva flow of no more than 0.2 mL/min or a stimulated whole saliva flow of no more than 0.7 mL/min. Results: Sixty-five patients underwent 131 I treatment (median age at evaluation, 33 y, with an interquartile range [IQR] of 25–40 y; 86.2% female; median follow-up period, 11 y, with an IQR of 6–22 y). Median cumulative 131 I activity was 5.88 GBq, with an IQR of 2.92–12.95 GBq, and 47.7% underwent multiple 131 I administrations. SGD was present in 30 (47.6%) patients. Levels of amylase and total protein in saliva were reduced. Moderate to severe xerostomia was present in 22 (35.5%) patients. Stimulated salivary secretion was lower and the severity of xerostomia complaints higher in patients treated with higher cumulative 131 I activity. Conclusion: In survivors of pediatric DTC, clinically significant SGD was found in 35.5% and was related to the cumulative 131 I activity of the treatment.

KW - Pediatric differentiated thyroid carcinoma

KW - Radioiodine treatment

KW - Salivary gland dysfunction

KW - Xerostomia

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U2 - 10.2967/jnumed.118.212449

DO - 10.2967/jnumed.118.212449

M3 - Article

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JO - Journal of Nuclear Medicine

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