Abstract
Context. Radioiodine (RAI) administration has adverse effects in patients treated for thyroid cancer (DTC), but there is scarce information regarding their intensity and duration. Objective. To evaluate frequency and intensity of early and late RAI-related symptoms in patients with DTC. Design. Observational prospective study. Patients. DTC patients who underwent thyroidectomy, with or without RAI. Measurements. Patients answered 2 surveys: (1) from 0 to 6 months and (2) between 6 and 18 months after initial treatment. Results. 110 patients answered the first survey and 61 both. Nearly 80 percent received RAI. Among early symptoms, periorbital edema, excessive tearing, salivary gland disturbances, dry mouth, taste disorders, and nausea were more frequent and intense among RAI patients. Regarding late symptoms, periorbital edema, salivary gland pain and swelling, and dry mouth were more frequent and intense in RAI patients. Frequency and intensity of adverse effects were not different between low and high RAI doses (50 versus ≥100 mCi). Conclusion. RAI-related symptoms are frequent and usually persist after 6 months of administration, even when low doses are given. This finding must be considered when deciding RAI administration, especially in low risk patients, among whom RAI benefit is controversial.
Highlights
The initial treatment of Differentiated Thyroid Cancer (DTC) includes surgery and selective administration of radioactive iodine (RAI) [1]
The benefit of RAI in low risk patients has not been fully supported by evidence [3,4,5,6] and current guidelines recommend an individualized approach for its indication [1, 7, 8]
Prospective study to evaluate and compare the frequency and intensity of early and late adverse effects associated with RAI administration in patients with DTC treated with total thyroidectomy
Summary
The initial treatment of Differentiated Thyroid Cancer (DTC) includes surgery and selective administration of radioactive iodine (RAI) [1]. RAI has shown to decrease mortality and recurrence in high risk patients, and it is considered an important component of the treatment in invasive or metastatic disease [1, 2]. Dysfunction may appear as salivary gland pain, taste impairment such as hypogeusia, xerostomia, sialolithiasis, dental caries, stomatitis, salivary gland or oral infections, facial nerve damage, and even salivary gland neoplasia [12]. These side effects may be persistent in nearly 7% of patients and profoundly impair patient quality of life (QoL) [13, 14]. The time course and resolution of lacrimal effects are not completely known [15]
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