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Long-Term Salivary Toxicity From Radioiodine Treatment of Thyroid Cancer

By: Susan Reckling
Posted: Monday, August 31, 2020

Although radioiodine is effective along with surgery in the treatment of differentiated papillary thyroid cancer, it has been associated with a high prevalence of side effects, particularly of the salivary and lacrimal glands. Based on the findings of a standardized questionnaire to more than 400 patients who underwent this treatment, most patients recover from the salivary side effects of this radiotherapy. However, Jean-Marc Foletti, MD, of Aix Marseille University Hospital, France, and colleagues noted that almost 30% of remissions in these patients occurred during late-stage follow-up. These findings were published in the journal Head & Neck.

“We can only strongly encourage long-term patients’ follow-up,” commented the investigators. “This study should also be used to provide patients with better information about side effects and their evolution over time.”

Initially, a standardized questionnaire was sent out in 2013 to 413 patients who received radioiodine treatment for differentiated papillary thyroid carcinoma between January 2011 and December 2012. This initial research intended to determine short-term toxicity. The more recent questionnaire, sent out to the same respondents in 2019, focused on long-term side effects of therapy, including discomfort in the submandibular or parotid area, swelling, pain, and a disagreeable or salty taste in the mouth.

A total of 239 respondents of the first questionnaire (58%) were reached in response to the second; nearly 80% (170 patients) responded to the most recent request. Most of the respondents were women (77.7%).

The comparison between the early and later questionnaires revealed a significant decrease in all symptoms (swelling, discomfort, pain, disagreeable taste in the mouth, diet modification, use of analgesics, and anxiety) except for xerostomia. In fact, xerostomia was the most frequent long-term salivary side effect, affecting 33.1% of 160 patients. The majority of patients (54.3%) had totally recovered from the salivary symptoms after 6 years. Of note, 69.3% had early-stage remission, and 30.7% had late-stage remission.

Disclosure: The study authors reported no conflicts of interest.

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