Incidence and risk factors for radioactive iodine-induced sialadenitis

Abstract

Background

Radioactive iodine (¹³¹I) is one of the treatments of hyperthyroidism and differentiated thyroid carcinoma (DTC). Swelling of salivary glands are one of the possible side effects of this treatment, known as radioactive iodine-induced sialadenitis (RAIS). The prevalence of RAIS varies widely and no specific risk ratio has been established.

Objectives

To determine the incidence of RAIS, analysing the epidemiological data and tumour- and treatment-related factors that may influence the development of the disease.

Material and methods

197 patients who received radioiodine treatment between 2015 and 2017 were studied (76.6% women). The variables studied were age, gender, weight, height, and body mass index; presence of high blood pressure, dyslipidemia, diabetes, and thyroid diseases; cumulative radioiodine dose, presence of sialadenitis, affected salivary gland, and the time of onset.

Results

14 patients developed sialadenitis (78.6% women), all with DTC. The incidence of sialadenitis was 3.4% overall and 6.3% among DTC patients. Furthermore, we found that higher cumulative radioiodine doses confer a greater risk of developing sialadenitis, with a hazard ratio of 1.009 (p = .001). No association was found between the epidemiologic data studied and sialadenitis.

Conclusions

In this series, a dose-dependent relationship was found between radioiodine treatment and sialadenitis.

Chinese abstract

背景：放射性碘（131I）是甲状腺功能亢进和分化甲状腺癌（DTC）的治疗方法之一。涎腺肿胀是该疗法的可能的副作用之一, 被称为放射性碘诱发的涎腺炎（RAIS）。 RAIS的患病率差异很大, 尚未确定具体的风险率。

目的：确定RAIS的发生率, 分析流行病学数据以及可能会影响疾病的发展的肿瘤相关和治疗相关的因素。

材料和方法：对2015年至2017年期间接受放射碘治疗的197例患者进行了研究（女性占76.6％）。研究的变量是年龄、性别、体重、身高和体重指数；高血压、血脂异常、糖尿病和甲状腺疾病的存在；累积放射性碘剂量、涎腺炎的存在、受影响的腺体和发病时间。

结果：14例患者患有涎腺炎（女性占78.6％）, 均患有DTC。涎腺炎的发生率总体为3.4％, 分化的甲状腺癌患者为6.3％。此外, 我们发现较高的放射性碘累积剂量会增加患上涎腺炎的风险, 风险率（HR）为1.009（p¼.001）。在所研究的流行病学数据与涎腺炎之间没有发现有相关性。

结论：该研究发现放射性碘治疗和涎腺炎之间存在剂量依赖性关系。

Keywords:

• Sialadenitis
• radioiodine
• thyroid cancer
• parotitis
• stricture
• sialendoscopy

Ethics approval

The study as approved following the guidelines of the hospital Research Ethics Committee before beginning. The patient expressly consented to the publication of this manuscript.

Disclosure statement

The authors declare that there is no conflict of interest that could be perceived as compromising the impartiality of the research reported.