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
UR - http://www.scopus.com/inward/record.url?scp=85060921439&partnerID=8YFLogxK
U2 - 10.2967/jnumed.118.212449
DO - 10.2967/jnumed.118.212449
M3 - Article
C2 - 30504138
AN - SCOPUS:85060921439
VL - 60
SP - 172
EP - 177
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
SN - 0161-5505
IS - 2
ER -