Complications of Radioactive Iodine Treatment of Thyroid Carcinoma

Radioactive iodine (RAI) in the form of I-131 has been used to treat thyroid cancer since 1946 RAI is used after thyroidectomy to ab late the residual normal thyroid remnant as adjuvant therapy and to treat thyroid cancer metastases Although the benefits of using RAI in low risk patients with thyroid cancer are debated it is frequently used in most patients with thyroid cancer and is clearly associated with acute and long term risks and side effects Acute risks associated with RAI therapy include nausea and vomiting ageusia (loss of taste) salivary gland swelling and pain Longer terrn complications include recurrent sialoadenitis associated with xerostomia mouth pain dental caries pulmonary fibrosis naso lacrimal outflow obstruction and second primary malignancies This article summarizes the common complications of RAI and methods to prevent and manage these complications (JNCCN 2010 8 1277-1287)