Int J Thyroidol.  2021 May;14(1):6-17. 10.11106/ijt.2021.14.1.6.

Clinical Outcome of Parotid Gland Massage for Preventing Parotid Gland Dysfunction in Patients Treated with Radioiodine Therapy for Differentiated Thyroid Cancer: a Prospective Longitudinal Follow-Up Study

• Son SH
• Hong CM
• Jeong SY
• Lee J
• Ahn BC

• KMID: 2516160
• DOI: http://doi.org/10.11106/ijt.2021.14.1.6

Abstract

Background and Objectives
The aim of this study was to determine the clinical effectiveness of parotid gland (PG) massage for the prevention of PG dysfunction after administration of radioiodine (I-131) therapy for treatment of differentiated thyroid cancer (DTC).
Materials and Methods
One hundred patients with DTC with planned high-dose I-131 therapy were enrolled in the clinical trial and randomized into two groups (massage and non-massage group). Serum amylase values were obtained before and 24 h after I-131 therapy, and salivary gland scintigraphy (SGS) were taken before and at eight months after the I-131 therapy. Additional SGS (addSGS) were taken when the patients complained symptoms related to salivary gland dysfunction. Questionnaire surveys were performed before and until two years after I-131 therapy.
Results
Ninety-five of 100 patients finished the study protocol. Changes in survey scores tended to be higher in the non-massage group. The non-massage group had more severe symptoms related to salivary gland dysfunction. Among 32 patients who underwent addSGS, 27 had normal 8-month SGS. Of these 27 patients, 18 (66.7%) had salivary gland dysfunction on the addSGS. Amylase values were significantly increased in patients with normal 8-month SGS but abnormal addSGS, as compared to patients who were normal on both 8-month SGS and addSGS (p=0.046). Amylase difference values were a significant predictor of abnormal addSGS (p=0.002). Conclusion: PG massage reduced symptoms related to salivary gland dysfunction. The PG massage may be helpful in preventing damage to salivary glands caused by I-131 therapy.

Keyword

I-131 therapy; Salivary gland massage; Prevention; Salivary gland dysfunction

Figure

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  Fig. 1 Schedule for salivary gland function assessment. ANA: antinuclear antibody, SSA: Sjögren syndrome antigen A, SSB: Sjögren syndrome antigen B

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  Fig. 2 Score change of the questionnaire not related to xerostomia.

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  Fig. 3 Score change of each question of the questionnaire not related to xerostomia.

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  Fig. 4 Score change of the questionnaire related to xerostomia.

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  Fig. 5 Score change of each question of the questionnaire related to xerostomia.

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  Fig. 6 Kaplan-Meier univariate analysis of *event-free survival (EFS) with respect to the amylase difference values. The amylase difference value significantly affected EFS.

Reference

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