Impact of sialendoscopy on improving health related quality of life in patients suffering from radioiodineinduced xerostomia

Olcay Cem Bulut; Sabine Haufe; Ralph Hohenberger; Matti Hein; Clemens Kratochwil; Hendrik Rathke; Peter K. Plinkert; Ingo Baumann; Tim Holland-Letz; Uwe Haberkorn; Paul Flechsig

doi:10.3413/Nukmed-0964-18-03

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2018; 57(04): 160-167
DOI: 10.3413/Nukmed-0964-18-03

Original Article

Georg Thieme Verlag

Impact of sialendoscopy on improving health related quality of life in patients suffering from radioiodineinduced xerostomia

Einfluss der Sialendoskopie auf die gesundheitsbezogenen Lebensqualität bei Patienten mit Radiojod-induzierter Xerostomie

Olcay Cem Bulut

¹Department of Otorhinolaryngology, University Hospital Heidelberg, Heidelberg, Germany

²Department of Otorhinolaryngology, SLK Kliniken – Klinikum Am Gesundbrunnen, Heilbronn, Germany

,

Sabine Haufe

³Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany

,

Ralph Hohenberger

¹Department of Otorhinolaryngology, University Hospital Heidelberg, Heidelberg, Germany

,

Matti Hein

²Department of Otorhinolaryngology, SLK Kliniken – Klinikum Am Gesundbrunnen, Heilbronn, Germany

,

Clemens Kratochwil

³Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany

,

Hendrik Rathke

³Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany

,

Peter K. Plinkert

¹Department of Otorhinolaryngology, University Hospital Heidelberg, Heidelberg, Germany

,

Ingo Baumann

¹Department of Otorhinolaryngology, University Hospital Heidelberg, Heidelberg, Germany

,

Tim Holland-Letz

⁴Department of Biostatistics, German Cancer Research Center, Heidelberg, Germany

,

Uwe Haberkorn

³Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany

⁵Clinical Cooperation Unit, Department of Nuclear Medicine, DKFZ, Heidelberg, Germany

,

Paul Flechsig

³Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany

› Author Affiliations

Abstract

Summary

Introduction: Xerostomia following radioiodine therapy (RIT) in patients suffering from differentiated thyroid cancer is a common side effect in 2 % to 67 % of patients treated with radioiodine (I-131). In order to evaluate the impact of sialendoscopy on health related quality of life (HRQOL) in patients suffering from therapy induced sialadenitis and xerostomia, we analyzed findings from two dedicated questionnaires (Xerostomy Questionnaire XQ and Xerostomy Inventory XI) in patients before and three months after sialendoscopy. Procedures: In total, 12 patients suffering from differentiated thyroid carcinoma (10 women and 2 men) were evaluated. All patients had experienced conservative management. Patients were offered a sialendoscopy procedure if no major contradictions were present. Patients who denied the procedure formed the control group. Pre- and (three months) postoperative HRQOL was measured with the Patient Reported Outcome Measures (PROM) Xerostomia Questionnaire (XQ) and the Xerostomia Inventory (XI), as well as by a pre- and post-interventional salivary gland scintigram. Patients were graded according to their sialendoscopical findings. Results: Interventional group presented with significant improvements in HRQOL measurements regarding XQ and XI-scores three months postoperatively. Control group showed no significant changes in the XQ or the XI scores. Number of RIT and cumulative activity of I-131 did not correlate with higher disease grade in regards to sialendoscopical findings nor did it correlate with higher XQand XI scores. Pre- and post-interventional salivary gland scintigram stated that parotid glands are more severely damaged than submandibular glands (SMG), but no significant scintigraphically changes could be detected after sialendoscopy. Conclusion: Sialendoscopy in patients suffering from therapy induced sialadenitis and xerostomia seems to be beneficial when evaluating the impact on HRQOL. Functional parameters measured by salivary gland scintigram did not show significant changes in post-interventional scintigrams.

Zusammenfassung

Einführung: Xerostomie nach Radiojodtherapie (RIT) bei Patienten mit differenziertem Schilddrüsenkrebs ist eine häufige Nebenwirkung bei 2 % bis 67 % der mit Radioiod behandelten Patienten (I-131). Um die Auswirkungen der Sialendoskopie auf die gesundheitsbezogene Lebensqualität (HRQOL) bei Patienten mit therapiebedingter Sialadenitis und Xerostomie zu untersuchen, wurden die Ergebnisse von zwei Fragebögen (Xerostomie Fragebogen XQ und Xerostomie Inventar XI) bei Patienten vor und nach drei Monate nach Sialendoskopie analysiert. Prozeduren: Insgesamt wurden 12 Patienten mit differenziertem Schilddrüsenkarzinom (10 Frauen und 2 Männer) untersucht. Alle Patienten hatten eine konservative Behandlung erfahren. Den Patienten wurde eine Sialendoskopie angeboten, wenn keine Kontraindikationen vorlagen. Patienten, die das Verfahren ablehnten, bildeten die Kontrollgruppe. Die prä- und dreimonatige postoperative HRQOL wurden mittels der XI- und XQ-Fragebögen ermittelt, sowie anhand eines prä- und post-interventionellen Speicheldrüsenszintigramms gemessen. Die Patienten wurden gemäß ihrer sialendoskopischen Befunde eingestuft. Ergebnisse: Die Interventionsgruppe zeigte drei Monate postoperativ signifikante Verbesserungen der HRQOL-Messungen bezüglich der XQ und XI-Scores. Die Kontrollgruppe zeigte keine signifikanten Veränderungen in den XQoder XI-Werten. Die Anzahl der RIT und die kumulative Aktivität von I-131 korrelierte weder mit einem höheren Grad der Erkrankung in Bezug auf sialendoskopische Befunde, noch korrelierte sie mit höheren XQ- und XI-Werten. Prä- und postinterventionelle Speicheldrüsenszintigramme zeigten, dass die Parotisdrüsen stärker geschädigt sind als die Submandibulardrüsen (SMG), nach der Sialendoskopie jedoch keine signifikanten szintigraphischen Verbesserungen nachweisbar sind. Fazit: Die Sialendoskopie bei Patienten mit therapiebedingter Sialadenitis und Xerostomie scheint einen positiven Einfluss auf die HRQOL zu haben. Funktionelle Parameter, wie sie in der Speicheldrüsen-Szintigraphie gemessen werden, zeigten jedoch post-interventionell keine signifikanten Verbesserungen.

Keywords

Sialendoscopy - radioiodine therapy - classification sialendoscopy - health-related quality of life - xerostomia - grading and classification sialadenitis

Schlüsselwörter

Sialendoskopie - Radiojodtherapie - Sialendoskopie-Klassifikation - gesundheitsbezogene Lebensqualität - Xerostomie - Grading und Klassifikation Sialadenitis

Full Text

References

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