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Cited by 197Thyroid Cancer Diagnosis and TreatmentThyroid and Parathyroid SurgeryThyroid Disorders and Treatments

Intermediate and long-term adverse effects of radioiodine therapy for differentiated thyroid carcinoma – A systematic review

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Clement, S.C., Peeters, R.P., Ronckers, C.M., Links, T.P., van den Heuvel-Eibrink, M.M., Nieveen van Dijkum, E.J.M., van Rijn, R.R., van der Pal, H.J.H. +4 more·2015·Cancer Treatment Reviews
DOI 10.1016/j.ctrv.2015.09.001
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Abstract

Background Treatment of differentiated thyroid carcinoma (DTC) often involves administration of radioactive iodine (I-131) for remnant ablation or adjuvant therapy. As DTC has favorable outcome and the incidence is increasing, concerns have been raised about the possible adverse effects of I-131 therapy. We systematically reviewed the literature to examine the risk of intermediate and long-term adverse effects of I-131 therapy in DTC patients.Methods Multiple electronic databases were searched up to November 2014 for English-language, controlled studies that reported on the risk of salivary gland dysfunction, lacrimal gland dysfunction, gonadal dysfunction, female reproductive outcomes or second primary malignancies (SPM) after I-131 exposure. The certainty of the evidence found was assessed using GRADE.Results In total, 37 articles met all inclusion criteria, no studies reporting on adverse effects after I-131 treatment focused solely on children. After exposure to I-131 for DTC, patients experienced significantly more frequently salivary gland dysfunction (prevalence range: 16-54%, moderate-level evidence), lacrimal gland dysfunction (prevalence: 11%, low-level evidence), transient male gonadal dysfunction (prevalence: 35-100%, high-level evidence), transient female gonadal dysfunction (prevalence: 28%, low-level evidence) and SPM (prevalence: 2.7-8.7%, moderate-level evidence) compared to unexposed patients. I-131 therapy seems to have no deleterious effects on female reproductive outcomes (very-low level evidence). The prevalence and severity of adverse effects were correlated to increasing cumulative I-131 activity.Conclusion Treatment with I-131 for DTC may have significant adverse effects, which seem to be dose dependent. These adverse effects of treatment must be balanced when choosing for I-131 therapy in patients with DTC.

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  • Some known inherited syndromes, such as ataxia telangiectasia, ataxia-telangiectasia-like disorder, radiosensitive severe combined immunodeficiency, Nijmegen breakage syndrome, and LIG4 deficiency, are associated with increased radiosensitivity.

    “some of the known inherited syndromes, such as ataxia telangiectasia, ataxia-telangiectasia-like disorder, radiosensitive severe combined immunode fi ciency, Nijmegen breakage syndrome, and LIG4 de fi ciency are associated with increased radiosensitivity ( 96 , 107 ).”

    From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [96]

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Authors
Clement, S. C., Peeters, R. P., Ronckers, C. M., Links, T. P., van den Heuvel-Eibrink, M. M., Nieveen van Dijkum, E. J. M., van Rijn, R. R., van der Pal, H. J. H., Neggers, S. J., Kremer, L. C. M., van Eck-Smit, B. L. F., & van Santen, H. M.
Affiliations
  • Amsterdam UMC Location University of Amsterdam (NL)
  • Erasmus MC (NL)
  • University Medical Center Groningen (NL)
Corresponding author
Clement, S.C.
ORCID
Venue
Cancer Treatment Reviews
Publisher
Elsevier BV
Published
2015-12
Volume
41
Issue
10
Pages
925-934
ISSN
0305-7372 (ISSN-L)
DOI
10.1016/j.ctrv.2015.09.001
OpenAlex
W2180354914
Cited by
197
References
46
Citations by year
2026: 9 · 2025: 12 · 2024: 15 · 2023: 18 · 2022: 22 · 2021: 21 · 2020: 21 · 2019: 10 · 2018: 47 · 2017: 8 · 2016: 11 · 2015: 1 · 2014: 1
FWCI
3.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Cancer Treatment Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Pure Amsterdam UMC (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Keywords
radioiodine therapy, iodine-131, differentiated thyroid cancer, adverse effects, salivary gland dysfunction, lacrimal gland dysfunction, gonadal dysfunction, second primary malignancy, cumulative radiation dose, dose-dependent toxicity
MeSH terms
Carcinoma, Eye Diseases, Female, Gonadal Disorders, Humans, Infertility, Female, Iodine Radioisotopes, Lacrimal Apparatus, Male, Neoplasms, Radiation-Induced, Oligospermia, Salivary Gland Diseases, Thyroid Neoplasms, Neoplasms, Second Primary

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