Long-term effects of radioiodine treatment on salivary gland function in adult survivors of pediatric differentiated thyroid carcinoma

Dutch Pediat Thyroid Canc Study Co, Tharsana Selvakumar, Marloes Nies, Marielle S. Klein Hesselink, Adrienne H. Brouwers, Anouk N. A. van der Horst-Schrivers, Esther N. Klein Hesselink, Wim J. E. Tissing, Arjan Vissink, Thera P. Links*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Pediatric differentiated thyroid cancer (DTC) is a rare disease. Initial treatment of DTC consists of a (near) total thyroidectomy and radioactive iodine (131I) therapy. Previous studies in adults showed that 131I treatment may result in a reduced salivary gland function. Studies regarding salivary gland function in children treated for DTC are sparse. Our aim was to assess long-term effects of 131I treatment on salivary gland function in survivors of pediatric DTC. Methods: In a nationwide cross-sectional study, salivary gland function of patients treated for pediatric DTC between 1970 and 2013 (>5 years after diagnosis, ≥18 years old at time of evaluation) was studied. Salivary gland function was assessed by sialometry, sialochemistry and a xerostomia inventory. Salivary gland dysfunction was defined as unstimulated whole saliva flow ≤0.2mL/min and/or a stimulated whole saliva flow ≤0.7 mL/min. Results: Sixty-five patients (median age at evaluation 33 [IQR, 25-40] years, 86.2% female, median follow-up period 11 [IQR, 6-22] years) underwent 131I treatment. Median cumulative 131I activity was 5.88 [IQR, 2.92-12.95] GBq, 47.7% underwent multiple 131I administrations. Salivary gland dysfunction 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 severity of xerostomia complaints higher in patients treated with higher cumulative 131I activity. Conclusion: In survivors of pediatric DTC, clinically significant salivary gland dysfunction was found in 35.5% and was related to the cumulative 131I activity of the treatment.

Original languageEnglish
Pages (from-to)172-177
Number of pages6
JournalJournal of Nuclear Medicine
Issue number2
Early online date30-Nov-2018
Publication statusPublished - 1-Feb-2019


  • pediatric differentiated thyroid carcinoma
  • radioiodine treatment
  • salivary gland dysfunction
  • xerostomia
  • I-131 THERAPY
  • RISK
  • FLOW

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