Tehran University of Medical Sciences
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Davood Beiki

Semi-quantitative assessment of salivary gland function in patients with differentiated thyroid carcinoma after radioiodine-131 treatment


Authors: Fard A, Fallahi B, Olamaei R, Eftekhari M, Beiki D, Saghari M,
Keywords: Radioiodine treatment, Salivary gland function, Scintigraphy of salivary gland, Differentiated thyroid carcinoma
Hell J Nucl Med , Vol.7, No.3, 2004,Page:206-209

Sialadenitis and xerostomia are well-known side effects of high-dose radioactive iodine ((131)Iota) treatment in patients with differentiated thyroid carcinoma (DTC). This study was undertaken to determine salivary gland function semi-quantitatively in patients with DTC given (131)I for the treatment of the thyroid remnant and/or metastases. Thirty-six patients, 11 males and 25 females, mean age 53.5 years, range 22-73 years, were studied. Scintigraphy of the salivary glands was performed with (99m)Tc-pertechnetate and the salivary excretion fraction (SEF) of the parotid and the submandibular glands was calculated as a measure of their function. Measurements were performed before (131)I treatment as a baseline study, and three weeks and three months later. The patients were clinically evaluated by a standardized subjective questionnaire. Results were as follows: Mean SEF at three weeks and three months after (131)I treatment was reduced as compared to baseline measurements. The total mean baseline measurements, those of three weeks and those of three months later were: 54.9%, 47.2% and 46% respectively; P<0.05 for both measurements (Table 1). The SEF decrease of the parotid glands was greater than that of the submandibular glands (P<0.05 as compared for both salivary glands before and three weeks and three months after (131)I treatment). This confirmed the higher radiosensitivity of the parotid glands as compared to the submandibular glands. In 12 patients (33%) there was no significant decrease of SEF in the salivary glands after (131)I treatment. The relation between the decrease of SEF after three weeks and after three months and the dose of (131)I administered, was for the right and left submandibular glands significant (P=0.016 and P=0.002), while for the parotid glands it was insignificant (P=0.22 and P=0.27 respectively) (Table 4). Reduction of SEF in the parotid glands three months after (131)I treatment was greater than after three weeks. This difference,