START (Salivary dysfuncTions After Radioiodine Treatment) Preliminary results of a self-controlled study in France

Autor: Baudin, Clemence, Lussey-Lepoutre, Charlotte, Bressand, Alice, Buffet, Camille, Menegaux, Fabrice, Soret, Marine, Broggio, David, Bassinet, Celine, Huet, Christelle, Ory, Catherine, Armengol, Gemma, Leenhardt, Laurence, Bernier, Marie Odile
Přispěvatelé: Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AMAREXIA France, F-75016, Paris, France, Groupe de recherche clinique Tumeurs Thyroïdiennes (GRC 16 - GRC-TT), Sorbonne Université (SU), Laboratoire d'Imagerie Biomédicale [Paris] (LIB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'évaluation de la dose interne (IRSN/PSE-SANTE/SDOS/LEDI), Service de dosimétrie (IRSN/PSE-SANTE/SDOS), Laboratoire de dosimétrie des rayonnements ionisants (IRSN/PSE-SANTE/SDOS/LDRI), CEA DRF, iBFJ, iRCM, and University Paris-Saclay, Fontenay-aux-Roses, France, Universitat Autònoma de Barcelona (UAB), Service de Médecine nucléaire [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe de recherche clinique 16 – Tumeurs Thyroïdiennes [CHU Pitié-Salpêtrière] (GRC-TT), Laboratoire d'Imagerie Biomédicale (LIB), ATHENA, Irsn
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: 5th European Radiation Protection Week (ERPW)
5th European Radiation Protection Week (ERPW), Nov 2021, ON LINE, France. 2021, ERPW
Popis: International audience; IntroductionThe treatment of differentiated thyroid cancer includes generally a total thyroidectomy, followed by a radioiodine (131I)-therapy. Due to their ability to concentrate iodine, the salivary glands may present inflammation after administration of 131I, which may be symptomatic, may lead to longer-term chronic abnormalities, resulting in alterations in patients’ nutrition and quality of life. The incidence of salivary dysfunctions after 131I-therapy varies considerably between studies due to methodological limitations. Also, the occurrence of these dysfunctions may be linked to increased uptake and/or retention of 131I in the salivary glands and/or individual radiosensitivity. However, no clinical or genetic factors have been identified to date to define patients at risk, allowing the delivered activity to be adapted to the expected risk of salivary dysfunctions. The aims of this study are 1) to estimate the incidence of salivary dysfunctions after 131I-therapy, 2) to investigate the risk of salivary dysfunctions in relation to 131I dosimeter recorded doses.MethodsThis prospective study included 139 patients, candidates for a 131I-therapy in the context of their differentiated thyroid cancer, treated in the Nuclear Medicine department of the Pitié-Salpêtrière hospital (45 and 94 patients in 1.1GBq and a 3.7GBq dose groups respectively) treated between September, 2020 and June, 2021. External thermoluminescent dosimeters were placed opposite the salivary glands and at the sternal fork immediately before radioiodine administration and removed 5 days after. The dose precisely received at the salivary glands was established from dosimeter records, physical and computational phantomsThe follow-up is based on 2 scheduled visits: at inclusion (T0, immediately before 131I-therapy) and 6 months after (T6). For each visit, questionnaires about salivary disorders (validated French tool) is administered, and individual measurements of the salivary flow (without and with salivary glands stimulation) are performed. Poisson regression models with adjustment for potential confounding factors will be used. ResultsThe T6 follow-up started in March, 2021, and is still ongoing. Statistical analyses will be set up in October, 2021, and results will be presented. Both subjective (questionnaire responses) and objective (saliva flow rates) indicators of salivary dysfunctions will be analysed, and a combined indicator will be created.DiscussionIt is the first study to investigate the risk of salivary dysfunctions (using both objective and subjective indicators) in relation to organ (salivary glands) doses, based on individual dosimeter records and dose reconstructions. Potential associated risk factors will be investigated. The results will allow the identification of patients at risk of salivary dysfunctions, and thus to propose to clinicians a more adapted follow-up and/or countermeasures to adverse effects.
Databáze: OpenAIRE
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