Changes in Serum Alkaline Phosphatase, Calcium, and Parathyroid Hormone with Different Doses of Iodine Therapy
AbstractBackground: Despite the benefits of radioactive iodine (RAI) therapy as an adjunctive treatment for thyroid cancer, it can be associated with several side effects. The main purpose of this study was to determine the changes in serum alkaline phosphatase (ALP), calcium (Ca), and parathyroid hormone (PTH) at different doses of RAI therapy among patients who were referred to the nuclear medicine department of Namazi Hospital, Shiraz. Materials and Methods: This cross-sectional study was conducted on 60 patients with papillary thyroid cancer who underwent RAI therapy at different doses of 100, 150, and 200 mCi. The ALP, Ca, and PTH levels of patients were measured before and 60 days after RAI therapy. Results: Our study revealed that RAI therapy at all doses significantly increased ALP level in comparison with baseline amounts (P≤0.05). However, changes in PTH and Ca levels were not significant among patients who received different doses of RAI (P˃0.05). Conclusion: RAI therapy could affect important hormones and enzymes such as ALP and PTH. This issue can be considered in diagnostic and therapeutic prescriptions of RAI for the treatment of thyroid cancer.
Lenzi M, Bassani G. The effect of radiation on the lymph and on the lymph vessels. Radiol. 1963;80(5):814-7.
Partington M, Craig AW, Jackson H. The effect of radiation on spermatogenic cells in the rat and mouse. Br J Radiol. 1962;35(418):713-8.
Kobayashi K, Usami N, Porcel E, Lacombe S, Le Sech C. Enhancement of radiation effect by heavy elements. Mutat Res. 2010;704(1-3):123-31.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49.
Parkin DM. Global cancer statistics in the year 2000. Lancet Oncol. 2001;2(9):533-43.
Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33.
Sturgeon KM, Deng L, Bluethmann SM, Zhou S, Trifiletti DM, Jiang C, et al. A population-based study of cardiovascular disease mortality risk in US cancer patients. Eur Heart J. 2019;40(48):3889-97.
Li LB, Wang JP, Yu XR, He SS, Yu FH, Ding CH. Medical radiation usage and exposures from medical X ray diagnosis in Shandong province of China. Radia Protect Dosi. 2001;93(3):261-6.
Creach KM, Siegel BA, Nussenbaum B, Grigsby PW. Radioactive iodine therapy decreases recurrence in thyroid papillary microcarcinoma. ISRN Endocrinol. 2012;2012:816386
Donya M, Radford M, ElGuindy A, Firmin D, Yacoub MH. Radiation in medicine: Origins, risks and aspirations. Glob Cardiol Sci Pract. 2014;2014(4):437-48
Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62(1):10-29.
Ahmad T, Khoja A, Rashid NH, Ashfaq MA. Outcome of radioactive iodine therapy in Toxic Nodular Goiter in Pakistan. Pak J Med Sci. 2018;34(5):1146-51
La Perle KM, Kim DC, Hall NC, Bobbey A, Shen DH, Nagy RS, et al. Modulation of sodium/iodide symporter expression in the salivary gland. Thyroid. 2013;23(8):1029-36.
Petrich T, Widjaja A, Musholt TJ, Hofmann M, Brunkhorst T, Ehrenheim C, et al. Outcome after radioiodine therapy in 107 patients with differentiated thyroid carcinoma and initial bone metastases: side-effects and influence of age. Europ J Nucl Med. 2001;28(2):203-8.
O'connor MK. The Mayo Clinic Manual of Nuclear Medicine. New York: Churchill Livingstone; 1996.
Frans JT, Berman DS, Maddahi J, Watson DD, Beller GA, Strauss HW, et al. Technetium-99m hexakis 2-methoxyisobutyl isonitrile: human biodistribution, dosimetry, safety, and preliminary comparison to thallium-201 for myocardial perfusion imaging. J Nucl Med. 1989;30(3):301-11.
Wang S, Liang C, Zhao L, Meng Z, Zhang C, Jia Q, et al. Influence of radioactive iodine therapy on liver function in patients with differentiated thyroid cancer. Nucl Med Commun. 2018;39(12):1113-20.
Fard-Esfahani A, Emami-Ardekani A, Fallahi B, Fard-Esfahani P, Beiki D, Hassanzadeh-Rad A, Eftekhari M. Adverse effects of radioactive iodine-131 treatment for differentiated thyroid carcinoma. Nucl Med Commun. 2014;35(8):808-17.
Guven A, Salman S, Boztepe H, Yarman S, Tanakol R, Azizlerli H, Alagol F. Parathyroid changes after high dose radioactive iodine in patients with thyroid cancer. Ann Nucl Med. 2009;23(5):437-41.
Lin Y. Internal radiation therapy: a neglected aspect of nuclear medicine in the molecular era. J Biomed Res. 2015;29(5):345-55.
Wyszomirska A. Iodine-131 for therapy of thyroid diseases. Physical and biological basis. Nucl Med Rev. 2012;15(2):120-3.
Rosen IB, Palmer JA, Rowen J, Luk SC. Induction of hyperparathyroidism by radioactive iodine. Amj Surg. 1984;148(4):441-5.
Kawamura J, Tobisu K, Sanada S, Okada Y, Yoshida O, Minami S, et al. Hyperparathyroidism after radioactive iodine therapy for Graves' disease: a case report. Hinyokika kiyo. Acta Urologica Japonica. 1983;29(11):1513-9.
Esselstyn Jr CB, Schumacher OP, Eversman J, Sheeler L, Levy WJ. Hyperparathyroidism after radioactive iodine therapy for Graves disease. Surg. 1982;92(5):811-3.
Ehrhardt JD Jr, Güleç S. A Review of the History of Radioactive Iodine Theranostics: The Origin of Nuclear Ontology. Mol Imaging Radionucl Ther. 2020;29(3):88-97.
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1-33.
Sokolov M, Neumann R. Changes in gene expression as one of the key mechanisms involved in radiation induced bystander effect. Bio Med Rep. 2018;9(2):99-111.
Mattar E, Salih MA, Alsafi K, Suliman II. Radiation Protection in The Release of Patients Receiving 131I Treatment. Radiat Prot Dosi. 2019;187(4):499-508.
Lu L, Shan F, Li W, Lu H. Short-Term Side Effects after Radioiodine Treatment in Patients with Differentiated Thyroid Cancer. Biomed Res Int. 2016;2016:4376720.
Wei S, Baloch ZW, LiVolsi VA. Parathyroid adenoma in patients with Graves' disease: a report of 21 cases. Endocr Pathol. 2015;26(1):71-4.
Szumowski P, Abdelrazek S, Mojsak M, Rogowski F, Kociura-Sawicka A, Myśliwiec J. Parathyroid gland function after radioiodine (131I) therapy for toxic and non-toxic goitre. Endokrynol Pol. 2013;64(5):340-5.
Iqbal AA, Burgess EH, Gallina DL, Nanes MS, Cook CB. Hypercalcemia in hyperthyroidism: patterns of serum calcium, parathyroid hormone, and 1,25-dihydroxyvitamin D3 levels during management of thyrotoxicosis. Endocr Pract. 2003;9(6):517-21.
Bassett JH, Williams GR. Role of Thyroid Hormones in Skeletal Development and Bone Maintenance. Endocr Rev. 2016;37(2):135-87.
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