Scholarlink

Background <p>Salivary gland dysfunction is a recognized complication of radioactive iodine (RAI) therapy for differentiated thyroid cancer. Oral sialagogues are commonly recommended, but their optimal timing remains uncertain. This systematic review compares early (&lt;24&#xa0;h) versus delayed (&gt;24&#xa0;h) sialagogue initiation.</p> Methods <p>A literature search was conducted in Embase, PubMed, CINAHL, and Cochrane from inception to January 2026. “Early” protocols initiated stimulation within 24&#xa0;h post-RAI, while “delayed” protocols initiated after 24&#xa0;h. Methodological quality and risk of bias were assessed using Cochrane’s ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions, 2016) tool.</p> Results <p>Three observational studies were included, comprising 818 adults with reported mean ages of 43–59 years. Interventions consisted primarily of lemon candy or oral vitamin C tablets. Primary outcomes included acute sialadenitis (pain and/or swelling), taste dysfunction, and xerostomia. Findings regarding acute salivary gland outcomes were inconsistent. Two earlier studies reported higher rates of acute sialadenitis with early stimulation (54.7–63.8% vs. 34.4–36.8%), taste dysfunction (37.5–39.0% vs. 18.8–25.6%), and xerostomia (23.8–46.9% vs. 11.2–29.7%) compared with delayed initiation. In contrast, the most recent propensity score-matched study, which evaluated a composite endpoint of acute salivary gland damage, reported lower event rates with early stimulation (4.78% vs. 15.22%).</p> Conclusion <p>This review underscores how evidence regarding the optimal timing of sialagogue initiation after RAI remains inconsistent. These heterogeneous findings highlight the need for high-quality randomized controlled trials to establish evidence-based recommendations for sialagogue timing after RAI therapy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Early versus delayed oral sialagogues for the prevention of salivary gland dysfunction after radioiodine therapy in differentiated thyroid cancer: a systematic review

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年8月3日

查看全文
  • Andressa Frankowski Dagostin,
  • Novel Yourdhan Rehandhika,
  • Ana Luiza Potiguara de Souza,
  • Soemiwati Holland

摘要

Background

Salivary gland dysfunction is a recognized complication of radioactive iodine (RAI) therapy for differentiated thyroid cancer. Oral sialagogues are commonly recommended, but their optimal timing remains uncertain. This systematic review compares early (<24 h) versus delayed (>24 h) sialagogue initiation.

Methods

A literature search was conducted in Embase, PubMed, CINAHL, and Cochrane from inception to January 2026. “Early” protocols initiated stimulation within 24 h post-RAI, while “delayed” protocols initiated after 24 h. Methodological quality and risk of bias were assessed using Cochrane’s ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions, 2016) tool.

Results

Three observational studies were included, comprising 818 adults with reported mean ages of 43–59 years. Interventions consisted primarily of lemon candy or oral vitamin C tablets. Primary outcomes included acute sialadenitis (pain and/or swelling), taste dysfunction, and xerostomia. Findings regarding acute salivary gland outcomes were inconsistent. Two earlier studies reported higher rates of acute sialadenitis with early stimulation (54.7–63.8% vs. 34.4–36.8%), taste dysfunction (37.5–39.0% vs. 18.8–25.6%), and xerostomia (23.8–46.9% vs. 11.2–29.7%) compared with delayed initiation. In contrast, the most recent propensity score-matched study, which evaluated a composite endpoint of acute salivary gland damage, reported lower event rates with early stimulation (4.78% vs. 15.22%).

Conclusion

This review underscores how evidence regarding the optimal timing of sialagogue initiation after RAI remains inconsistent. These heterogeneous findings highlight the need for high-quality randomized controlled trials to establish evidence-based recommendations for sialagogue timing after RAI therapy.