Nasal Symptoms After Radioiodine Therapy: A Rarely Described Side Effect with Similar Frequency to Lacrimal Dysfunction
Nasal Symptoms After Radioiodine Therapy: A Rarely Described Side Effect with Similar Frequency to Lacrimal Dysfunction
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DOI：
10.1089/thy.2014.0162
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发表时间：
2014-12-01
期刊：
影响因子：
6.6
通讯作者：
Jonklaas, Jacqueline
中科院分区：
文献类型：
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作者：
Jonklaas, Jacqueline
背景：放射性碘治疗的唾液和泪液副作用已被仔细描述。然而，鼻腔副作用很少被描述。本研究的目的是将鼻腔副反应的发生率与已有文献记载的泪道副反应进行比较，并确定相关的危险因素。方法：对807例在学术医学中心接受治疗的分化型甲状腺癌患者的病历进行了回顾。411名接受放射性碘(RAI)治疗的患者被确认并纳入分析。确定鼻腔和泪道副作用的发生率。可能导致患者在RAI治疗后遭受鼻部损伤的因素也被记录在案。这些因素包括放射性碘剂量、接受RAI治疗的准备方法和患者特征。结果：RAI的平均剂量为109mCI。RAI治疗后，43例患者(10.5%)和40例患者(9.7%)出现鼻腔和泪道副作用。鼻部症状的平均出现时间为11天，而泪液症状的平均出现时间为10个月。放射性碘剂量和体重指数分别与鼻腔持续副作用呈显著正相关和显著负相关(p值分别为0.04和0.01)。类似地，RAI剂量和体重指数与持续泪道副作用显著相关，分别为正相关和负相关(p值分别为0.02和0.01)。与重组人促甲状腺激素(RhTSH)方案相比，使用停药方案的准备治疗与鼻腔和泪道副作用的风险增加相关(p值
Background: Salivary and lacrimal side effects of radioiodine therapy have been carefully described. However, nasal side effects are rarely described. The objective of this study was to document the frequency of nasal side effects in comparison to the already well-documented lacrimal side effects and to determine contributing risk factors.Methods: A retrospective review of the medical records of 807 patients with differentiated thyroid cancer who received care at an academic medical center was conducted. Four hundred eleven patients who received treatment with radioactive iodine (RAI) were identified and included in the analysis. The frequency of both nasal and lacrimal side effects was ascertained. Factors that may have contributed to patients sustaining nasal damage after RAI therapy were also documented. These factors included radioactive iodine dose, method of preparation for receiving RAI therapy, and patient characteristics.Results: The mean dose of RAI administered was 109 mCi. Forty-three patients (10.5%) and 40 patients (9.7%) developed nasal and lacrimal side effects, respectively, following RAI treatment. The mean time of onset of nasal symptoms was 11 days, compared with 10 months for lacrimal symptoms. Radioiodine dose and body mass index were significantly positively and negatively correlated, respectively, with sustaining nasal side effects (p values of 0.04 and 0.01, respectively). Similarly, both RAI dose and body mass index were significantly correlated, positively and negatively, respectively, with sustaining lacrimal side effects (p values of 0.02 and 0.01). Preparation for treatment using a withdrawal protocol was associated with increased risk of both nasal and lacrimal side effects, compared with a recombinant human thyrotropin (rhTSH) protocol (p values of