ABB  Vol.5 No.5 , April 2014
Evaluation of Quality of Life Related to I-131 Therapy in Patients with Well-Differentiated Thyroid Cancer and Emphasis in Salivary Morbidity: A Follow up Study after Treatment
Abstract: Goal: To evaluate the impact of iodine-131 therapy received during childhood and adolescence and correlate it with the quality of life in these patients. Methods: We studied 19 patients diagnosed with cancer in childhood or adolescence who underwent thyroidectomy and supplemental therapy with I-131. We also recruited a control group of healthy subjects with the same demographic parameters. All patients were subjected to a scintigraphy examination of the salivary glands, and were also asked to complete a questionnaire in order to assess their overall quality of life. In addition, a more specific questionnaire for patients with head and neck cancer was also given to all study participants. Results: The quantitative and qualitative analyses of the salivary glands showed functional deficits with greater involvement of the parotid gland for volume, concentration and excretion. The right submandibular gland showed significant changes for volume in the patient group. The questionnaires made it possible to observe significant differences between the patient and control groups for symptoms such as thick saliva, dry mouth and speech problems. Conclusion: In spite of being very effective and widely used, iodine radionuclide therapy is correlated with a lower quality of life in young people.
Cite this paper: Corrêa, L. , Moriguchi, S. , Boldrini, É. , Carvalho, A. , Guerreiro Fregnani, J. and da Rocha, E. (2014) Evaluation of Quality of Life Related to I-131 Therapy in Patients with Well-Differentiated Thyroid Cancer and Emphasis in Salivary Morbidity: A Follow up Study after Treatment. Advances in Bioscience and Biotechnology, 5, 409-417. doi: 10.4236/abb.2014.55049.

[1]   McClellan, D.R. and Francis, G.L. (1996) Thyroid Cancer in Children, Pregnant Women, and Patients with Graves’ Disease. Endocrinology Metabolism Clinics of North America, 25, 27-48.

[2]   Robbins, R.J. and Schlumberger, M.J. (2005) The Evolving Role of 131I for the Treatment of Differentiated Thyroid Carcinoma. Journal of Nuclear Medicine, 46, 28S-37S.

[3]   O’gorman, C.S., Hamilton, J., Rachmiel, M., Gupta, A., Ngan, B.Y. and Daneman, D. (2010) Thyroid Cancer in Childhood: A Retrospective Review of Childhood Course. Thyroid, 20, 375-380.

[4]   Newkirk, K.A., Ringel, M.D., Wartofsky, L. and Burman, K.D. (2000) The Role of Radioactive Iodine in Salivary Gland Dysfunction. Ear, Nose & Throat Journal, 79, 460-468.

[5]   Gorlin, J.B. and Sallan, S.E. (1990) Thyroid Cancer in Childhood. Endocrinol Metab Clin North Am, 24, 649-62.

[6]   Caglar, M., Tuncel, M. and Alpar, R. (2002) Scintigraphic Evaluation of Salivary Gland Dysfunction in Patients with Thyroid Cancer after Radioiodine Treatment. Clinical Nuclear Medicine, 27, 767-771.

[7]   Helman, J., Turner, R.J., Fox, P.C. and Baum, B.J. (1987) 99mTc-Pertechnetate Uptake in Parotid Acinar Cells the Na+/K+/Cl- co-Transport System. Journal of Clinical Investigation, 79, 1310-1313.

[8]   Newkirk, K.A., Ringel, M.D., Wartofsky, L. and Burman, K.D. (2000) The Role of Radioactive Iodine in Salivary Gland Dysfunction. Ear, Nose & Throat Journal, 79, 460-468.

[9]   Mandel, S.J. and Mandel, L. (2003) Radioactive Iodine and the Salivary Glands. Thyroid, 13, 265-271.

[10]   Alexander, C., Bader, J.B., Schaefer, A., Finke, C. and Kirsch, C.M. (1998) Intermediate and Long-Term Side Effects of High-Dose Radioiodine Therapy for Thyroid Carcinoma. Journal of Nuclear Medicine, 39, 1551-1554.

[11]   Taïeb, D., Baumstarck-Barrau, K., Sebag, F., Fortanier, C., De Micco, C., Loundou, A., et al. (2011) Heath-Related Quality of Life in Thyroid Cancer Patients Following Radioiodine Ablation. Health and Quality of Life Outcomes, 13, 33.

[12]   Campolina, A.G. and Ciconelli, R.M. (2006) Qualidade de Vida e Medidas de Utilidade: Parametros Clínicos Para as Tomadas de Decisão em Saúde. Revista Panamericana de Salud Pública/Pan American Journal of Public Health, 19, 128-136.

[13]   Prebianchi, H.B. (2005) Medidas de Qualidade de Vida Para Crianç&as: Aspectos Conceituais e Metodológicos. Psicologia: Teoria e Prática, 5, 57-69.

[14]   Gough, I.R. (1994) Quality of Life as an Outcome Variable in Oncology and Surgery. Australian and New Zealand Journal of Surgery, 64, 227-235.

[15]   European Organization for Research and Treatment of Cancer (EORTC).

[16]   Vartanian, J.G., Carvalho, A.L., Furia, C.L.B., Castro, Jr., G., Rocha, C.N., Sinitcovisky, I.M.L., et al. (2007) Questionnaries Validated in Brazilian Population for Evaluation of the Quality of Life in Patients with Head and Neck Cancer. Revista Brasileira de Cirurgia de Cabeç&a e Pescoç&o, 36, 108-115.

[17]   Jeong, S.Y., Kim, H.W., Lee, S.W., Ahn, B.C. and Lee, J. (2013) Salivary Gland Function 5 Years after Radioactive Iodine Ablation in Patients with Differentiated Thyroid Cancer: Direct Comparison of Pre- and Posablation Scintigraphies and Their Relation to Xerostomia Symptoms. Thyroid, 23, 609-616.

[18]   Rosario, P.W.S., Cardoso, L.D., Barroso, A.L., Padrao, E.L., Rezende, L.L. and Purisch, S. (2005) Safety of Radioiodine Therapy in Patients with Thyroid Carcinoma Younger than 21 Years. Arquivos Brasileiros de Endocrinologia & Metabologia, 49, 241-245.

[19]   Roach, M.C., Turkington, T.G., Higgins, K.A., Hawk, T.C., Hoang, J.K. and Brizel, D.M. (2012) FDG-PET Assessment of the Effect of Head and Neck Radiotherapy on Parotid Gland Glucose Metabolism. International Journal of Radiation Oncology Biology Physics, 82, 321.

[20]   Olmos, R.A.V., Keus, R.B., Takes, R.P., van Tinteren, H., Baris, G., Hilgers, F.L.M., et al. (1994) Scintigraphic Assessment of Salivary Function and Excretion Response in Radiation-Induced Injury of the Major Salivary Glands. Cancer, 73, 2886-2893.<2886::AID-CNCR2820731203>3.0.CO;2-K

[21]   Dingle, F., Mishoe, A.E., Nguyen, S.A., Overton, L.J. and Gillespie, M.B. (2013) Salivary Morbity and Quality of Life Following Radioactive Iodine for Well-Differentiated Thyroid Cancer. Otolaryngology—Head and Neck Surgery, 148, 746-752.

[22]   Almeida, J., Vartanian, J.G. and Kowalski, L.P. (2009) Evaluation of Adjuvant Radioactive Iodine Therapy Side Effects on Salivary Glands in Patients with Well-Differentiated Thyroid Carcinoma. Archives of Otolaryngology—Head and Neck Surgery, 135, 342-346.

[23]   Richter, R., Oskay-Oezcelik, G., Chekerov, R., Pilger, A., Hindenburg, H.J., Sommer, H., et al. (2012) Health-Related Quality of Life during Sequential Chemotherapy with Carboplatin Followed by Weekly Paclitaxel in Advanced Ovarian Cancer: A Multicenter Phase II Study of the North Eastern German Society of Gynecological Oncology. Anticancer Research, 32, 3969-3976.

[24]   Bushnell, D.L., Boles, M.A., Kaufman, G.E., Wadas, M.A. and Barnes, E. (1992) Complications, Sequela and Dosimetry of Iodine-131 Therapy for Thyroid Carcinoma. Journal of Nuclear Medicine, 33, 2214-2221.

[25]   Vissink, A., Jansma, J., Spiikervet, F.K., Burlage, F.R. and Coppes, R.P. (2003) Oral Sequelae of Head and Neck Radiotherapy. Critical Reviews in Oral Biology & Medicine, 14, 199-212.

[26]   Mendoza, A., Shaffer, B., Karakla, D., Mason, M.E., Elkins, D. and Goffman, T.E. (2004) Quality of Life with Well-Differentiated Thyroid Cancer: Treatment Toxicities and Their Reduction. Thyroid, 14, 133-140.

[27]   Braz, D.S.A., Ribas, M.M., Dedivitis, R.A., Nishimoto, I.N. and Barros, A.P.B. (2005) Quality of Life and Depression in Patients Undergoing Total and Partial Laryngectomy. Clinics, 60, 135-142.

[28]   Challinor, J.M., Miaskowski, C.A., Franck, L.S., Slaughter, R.E., Matthay, K.K., Kramer, R.F., et al. (1999) Somatization, Anxiety and Depression as Measures of Health-Related Quality of Life of Children/Adolescents with Cancer. International Journal of Cancer. Supplement, 12, 52-57.<52::AID-IJC10>3.0.CO;2-J

[29]   Moore, I.M., Challinor, J., Pasvogel, A., Matthay, K., Hutter, J. and Kaemingk, K. (2003) Online Exclusive: Behavioral Adjustment of Children and Adolescents with Cancer: Teacher, Parent, and Self-Report. Oncology Nursing Forum, 30, 84-91.