Seeking optimal management for radioactive iodine therapy-induced adverse effects

AbstractObjectiveTo detect whether the adverse effects of post-operative radioactive iodine therapy following differentiated thyroid cancer on smell, taste and nasal functions were associated with radioactive iodine dose.MethodsFifty-one patients who had undergone total thyroidectomy because of differentiated thyroid cancer were divided into two groups depending on the post-operative radioactive iodine therapy dose: low dose group (50 mCi; 21 patients) and high dose group (100–150 mCi; 30 patients). The Sniffin’ Sticks smell test, the Taste Strips test and the 22-item Sino-Nasal Outcome Test were performed on all patients one week before therapy, and at two months and one year following therapy.ResultsStatistically significant differences were detected in the Sniffin’ Sticks test results, total odour scores, total taste scores and Sino-Nasal Outcome Test results between the assessment time points. There was no statistically significant difference between the low and high dose groups in terms of odour, taste or Sino-Nasal Outcome Test scores either before or after therapy.ConclusionRadioactive iodine therapy has some short- and long-term adverse effects on nasal functions and taste and odour sensations, which affect quality of life. These effects are not dose-dependent.

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Sinusitis, an under-reported adverse effect in children treated with radioactive iodine therapy and review of the current literature

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0304 ◽

2020 ◽

Vol 33 (1) ◽

pp. 171-173 ◽

Cited By ~ 2

Author(s):

Elizabeth T. Walsh ◽

Janel D. Hunter ◽

David F. Crudo ◽

Cathrine Constantacos

Keyword(s):

Adverse Effect ◽

Adverse Effects ◽

Current Literature ◽

Facial Pain ◽

Radioactive Iodine ◽

Graves Disease ◽

Radioactive Iodine Therapy ◽

Pediatric Case ◽

Case Presentation ◽

A Site

AbstractBackgroundRadioactive iodine (RAI) therapy is prevalent in the treatment of Graves’ disease. Adverse effects in pediatrics are not well-described.Case presentationA 13-year-old female underwent RAI therapy for Graves’ disease. Eight days later, she developed facial pain and forehead burning. She was diagnosed with sinusitis and started on pseudoephedrine with resolution in 24 h.ConclusionsShe endured prolonged discomfort due to an under-recognized adverse effect of RAI. Studies identify the nose as a site of RAI accumulation and smaller nasal passages may predispose children to sinusitis. We report the first pediatric case of sinusitis following RAI. With the increasing use of RAI to treat Graves’ disease, clinicians must recognize this adverse effect.

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Prospective Single-Arm Study of Radioprotection by Amifostine in High Dose Radioactive Iodine Therapy for Thyroid Cancer

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1019 ◽

2012 ◽

Vol 46 (2) ◽

pp. 90-94

Author(s):

Ajay Sandhu ◽

Vladimir Ioffe ◽

Daniel Karakla ◽

J Trad Wadsworth ◽

April Mendoza ◽

...

Keyword(s):

Thyroid Cancer ◽

Adverse Effects ◽

Differentiated Thyroid Cancer ◽

Radioactive Iodine ◽

High Dose ◽

Radioactive Iodine Therapy ◽

F Test ◽

Significant Treatment ◽

Duration Of Symptoms ◽

Taste Dysfunction

ABSTRACT Purpose Xerostomia, sialoadenitis, taste dysfunction and nausea are well known toxicities following high dose radioactive iodine (RAI) treatment for well-differentiated thyroid cancer. This prospective study sought to determine the incidence rates for RAI adverse effects and to determine, whether the radioprotector, amifostine could decrease the duration of the adverse effects in single treatment patients. Materials and methods Patients with differentiated thyroid cancer received 150 mCi RAI after total thyroidectomy. All patients were pretreated with 1 mg granisetron and 4 mg dexamethasone. Patients in the amifostine arm (n = 27) were prospectively enrolled and received 500 mg amifostine subcutaneously. Adverse effects were scored based on the CTCAE at 1 month, 6 months, and yearly intervals using a physician administered questionnaire. The results were compared with a retrospective no amifostine cohort (n = 22) for whom data was collected with the identical questionnaire. Results The overall incidence of xerostomia, sialadenitis, taste dysfunction and nausea in the treatment group was 26, 22, 52 and 26% respectively. Only grades 1 and 2 adverse effects were observed. The mean duration (days) of xerostomia (control vs treatment)—37.3 vs 21.9 (F test, p = 0.016), taste dysfunction—45.5 vs 23.5 (F test, p = 0.001), sialadenitis— 16.8 vs 7.5 and nausea—18.7 vs 5.1. Conclusion In patients treated once with high dose RAI, who develop xerostomia, sialoadenitis, taste dysfunction, and/or nausea, the duration of symptoms appears to be reduced by pretreatment with 500 mg of subcutaneous amifostine without significant treatment related adverse effects. How to cite this article Sandhu A, Ioffe V, Karakla D, Wadsworth JT, Mendoza A, Rao N, Dignan K, Mason E, Goffman TE. Prospective Single-Arm Study of Radioprotection by Amifostine in High Dose Radioactive Iodine Therapy for Thyroid Cancer. J Postgrad Med Edu Res 2012;46(2):90-94.

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