Salivary Morbidity following Radioactive Iodine

Abstract

Objective: 1) Determine the prevalence of sialoadenitis in patients treated with radioactive iodine (RAI) for well-differentiated thyroid cancer. 2) Determine if a reduction in swallowing-related or global head and neck quality of life exists in patients treated with RAI. 3) Assess any dose dependence of the primary objectives.

Method: Surviving patients seen at the MUSC Hollings Cancer Center for well-differentiated thyroid cancer were identified by review of the Hollings Cancer Center Registry. Patients were mailed a baseline questionnaire, the M.D. Anderson Dysphagia Inventory, the University of Washington Quality of Life Questionnaire, and the Xerostomia Quality of Life Survey.

Results: Surveys were mailed to 379 patients and 145 were returned (38%). The study included 121 women and 24 men, with a mean age of 52. RAI exposure was correlated with an increase in sialoadenitis and was dose dependent (R² = 0.336, P < .001). Of the 41 patients who received 100 or less millicuries (mCi), none reported sialoadenitis, compared to 17 (25%) of 69 patients who received 101 to 200 mCi, and 12 (39%) of 30 patients who received greater than 200 mCi (P = .001). RAI exposure was not correlated with a reduction in swallowing-related or global head and neck quality of life.

Conclusion: Patients treated with RAI exhibited an increased risk for sialoadenitis but no reduction in swallowing-related or global head and neck quality of life. Our findings suggest these patients should be screened for salivary morbidity and may benefit from prophylactic treatments aimed at protecting the salivary glands prior to RAI exposure.