The dental safety profile of high-dose radioiodine therapy for thyroid cancer: long-term results of a longitudinal cohort study.
The long-term dental safety profile of high-dose radioiodine therapy remained elusive despite more than 6 decades of clinical use.


METHODS
In a cohort study, we investigated the incidence of sialadenitis, xerostomia, caries, and tooth extractions after high-dose radioiodine therapy for differentiated thyroid cancer and explored risk factors by multiple regression models.


RESULTS
One hundred seventy-six participants were recruited (median follow-up, 6.6 y; range, 1.1-32.6 y; patient-years: 8,472 before and 1,421 after radioiodine therapy). Scintigraphic salivary gland uptake during radioiodine treatment predicted development of sialadenitis (odds ratio: 1.31 [1.05-1.63], P = 0.015) and xerostomia (odds ratio: 1.58 [1.16-2.16], P = 0.004). The caries risk increased by postradioiodine xerostomia (% increase: 98.8 [26.5-212], P = 0.003). The long-term risk for postradioiodine tooth extractions increased with increasing cumulative radioiodine activities (% increase [per gigabequerel]: 8.14 [1.07, 15.7], P = 0.02).


CONCLUSIONS
High-dose radioiodine treatment can impair the long-term dental health, depending on the cumulative radioiodine activity and individual salivary gland radioiodine uptake.
Walter
Martin A
MA
Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland. m.a.walter@gmx.net
Turtschi
Christian P
CP
Schindler
Christian
C
Minnig
Peter
P
Müller-Brand
Jan
J
Müller
Beat
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000453:epidemiology* / Q000517:prevention & control; D011835:Radiation Protection / Q000379:methods*; D011879:Radiotherapy Dosage; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D009057:Stomatognathic Diseases / Q000453:epidemiology* / Q000517:prevention & control; D013557:Switzerland / Q000453:epidemiology; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy*