Salivary gland damage in radioiodine therapy. Dosimetry results and their implications

Radioiodine therapy plays a key role in the management of patients with differentiated thyroid cancer. However, radioiodine is concentrated not only in the target tissues but also by other tissue expressing sodium/iodine symporters - in particular the submandibular and parotid salivary glands. As a consequence, high-activity radioiodine therapy may be associated with unwanted radiogenic salivary gland damages. As a consequence, the most frequently observed adverse short- and long-term side effects of radioiodine therapy include sialoadenitis and some degree of xerostomia, both with a potentially negative impact on quality of life. In this review, we highlight the function and importance of salivary glands and discuss the current results of dosimetry studies of the salivary glands in patients, who undergo radioiodine therapy. Based on the dosimetry findings, the commonly applied radioprotective procedure to diminish damage to the salivary glands are discussed critically. (orig.)