title: Risk Factors of131I-Induced Salivary Gland Damage in Thyroid Cancer Patients.
abstract: Sialadenitis and xerostomia are major adverse effects of131I therapy in thyroid cancer patients. The risk factors for these adverse effects, other than administered activity of131I, have not been investigated.
  
  
  
  The aim of this study is to identify risk factors for131I-induced salivary gland damage among follicular cell-derived thyroid cancer patients.
  
  
  
  We enrolled 216 thyroid cancer patients who visited The Ohio State University Wexner Medical Center between April 2013 and April 2014. Symptoms of xerostomia and sialadenitis were identified via questionnaire and medical record search. To validate the findings in a large cohort, we retrospectively searched for ICD-9/10 codes for sialadenitis, xerostomia, and autoimmune disease associated with Sjögren's syndrome (AID-SS) in our existing database (n = 1507). Demographic and clinical information was extracted from medical records. Multivariate analyses were performed to identify independent predictors for salivary gland damage.
  
  
  
  131I treatment associated with higher incidence of xerostomia and sialadenitis. Patients with xerostomia had 46 mCi higher mean cumulative131I activity and 21 mCi higher mean first-administered131I activity than patients without xerostomia. Increased age associated with higher incidence of xerostomia, and females had a higher incidence of sialadenitis. Patients who experienced sialadenitis before131I therapy had higher sialadenitis incidence after131I therapy.131I-treated patients diagnosed with AID-SS, whether before or after131I treatment, had a higher incidence of xerostomia and sialadenitis among131I-treated patients.
  
  
  
  Risk factors for131I-induced salivary gland damage include administered131I activity, age, gender, history of sialadenitis before131I treatment, and AID-SS diagnosis.
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Brynn
authors.initials: B
authors.lastname: Hollingsworth
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Leigha
authors.initials: L
authors.lastname: Senter
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Guy N
authors.initials: GN
authors.lastname: Brock
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Wael
authors.initials: W
authors.lastname: Jarjour
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Nagy
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Pamela
authors.initials: P
authors.lastname: Brock
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Coombes
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Kloos
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Ringel
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sipos
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Ilene
authors.initials: I
authors.lastname: Lattimer
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Carrau
authors.affiliation: Department of Physiology and Cell Biology (B.H., S.M.J.), Human Cancer Genetics Program, Comprehensive Cancer Center (L.S., R.N., P.B., I.L.), Center for Biostatistics (X.Z., G.N.B.), Department of Internal Medicine, Division of Rheumatology and Immunology (W.J.), Department of Biomedical Informatics (X.Z., G.N.B., K.R.C.), Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism (R.K., M.D.R., J.S.), Department of Internal Medicine, Division of Oncology (M.D.R.), and Department of Otolaryngology-Head & Neck Surgery (R.C.), The Ohio State University, Columbus, Ohio 43210.
authors.forename: Sissy M
authors.initials: SM
authors.lastname: Jhiang
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D012737:Sex Factors; D012793:Sialadenitis / Q000453:epidemiology / Q000209:etiology*; D012859:Sjogren's Syndrome / Q000453:epidemiology; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery; D013965:Thyroidectomy; D014987:Xerostomia / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes