Assessment of the chronic injury of salivary glands in patients with differentiated thyroid cancer who underwent comprehensive intervention measures with first ¹³¹I clearing therapy

Objective: To study the effect of first time ¹³¹I clearance therapy on chronic salivary gland function in patients with differentiated thyroid cancer (DTC) after comprehensive intervention. Methods: Fifty-two cases of DTC patients who were treated with ¹³¹I [(4200.24 ± 604.21) MBq] clearance for the first time in the Department of Nuclear Medicine in Panzhihua Central Hospital were selected from August 2016 to September 2017. All patients were treated with ¹³¹I clearance immediately after the comprehensive intervention (diet nursing, psychological nursing, physical nursing, oral health care, health education, and drug therapy) and before and 6 months after treatment. Moreover, patients underwent ⁹⁹Tc^mO₄^- salivary gland scintigraphy, and the peak uptake and excretion fraction (%) were calculated. The obtained data were analyzed by self-compared t test. The dry mouth scores of salivary gland function damage were also evaluated. Results: (1) The peak uptake of the left parotid gland before ¹³¹I clearance and after 6 months of treatment was 45.157 ± 19.421 and 52.600 ± 21.716, respectively. The difference was statistically significant (t = 2.470, P = 0.018). (2) No significant difference was observed in the peak values between the right parotid and bilateral submandibular gland and between the bilateral parotid and bilateral submandibular glands(t = 0.784, 0.524, 0.514, 0.362, 0.731, 0.596, 0.507, all P > 0.05). (3) Fifty-two patients were analyzed by using questionnaires and dry mouth scores. Result showed that 50 cases (96.2%) indicated no xerostomia, and only two cases (3.8%) presented mild xerostomia. Conclusions: (1) The first ¹³¹I treatment can cause salivary gland dysfunction in patients with DTC. This damage is mainly unilateral parotid gland uptake, which is an asymmetrical injury. Additionally, the uptake and excretory function of bilateral submandibular glands are not significantly affected. (2) Approximately 96.2% patients showed no significant dry mouth after receiving ¹³¹I clearance treatment for 6 months. Therefore, the intervention exerted significant effects on the quality of life of patients. (authors)