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The Preventive Effect of Parotid Gland Massage on Salivary Gland Dysfunction During High-Dose Radioactive Iodine Therapy for Differentiated Thyroid Cancer

A Randomized Clinical Trial

Son, Seung Hyun MD*,†; Lee, Chang-Hee MD*,†; Jung, Ji-Hoon MD*,†; Kim, Do-Hoon MD*,†; Hong, Chae Moon MD*,†; Jeong, Ju Hye MD*,†; Jeong, Shin Young MD, PhD*,†; Lee, Sang-Woo MD, PhD*,†; Lee, Jaetae MD, PhD*,†; Ahn, Byeong-Cheol MD, PhD*,†

doi: 10.1097/RLU.0000000000002602
Original Articles

Purpose To evaluate the preventive effect of parotid gland (PG) massage for PG damage during the 131I therapy, we prospectively investigated the serum amylase value and salivary gland scintigraphy (SGS) after 131I therapy.

Materials and Methods One hundred patients with thyroidectomized differentiated thyroid cancer who underwent high-dose 131I therapy were enrolled in the clinical trial and randomized into 2 groups (PG massage group and nonmassage group). The serum amylase value was obtained before and 24 hours after 131I therapy, and the SGSs were also taken just before and at 8 months after the 131I therapy. Change in serum amylase value and SGS was compared between PG massage and nonmassage groups.

Results The difference value of serum amylase was significantly lower in PG massage group than in nonmassage group (P = 0.0052). Worsening of PG function on SGS was observed in 43 (45.3%) of the 95 patients. The incidence rate of PG abnormality on F/U SGS was significantly lower in PG massage group than in nonmassage group (odds ratio, 0.3704; P = 0.0195). In the multiple regression analysis, PG massage significantly affected the abnormality on the 8-month F/U SGS (rpartial = −0.2741, P = 0.0090) after adjusting for clinical variables (age, sex, TNM stage, TSH preparation methods for the 131I therapy, and 131I dose).

Conclusions PG gland massage significantly reduced the incidence rates of salivary gland dysfunction on the 8-month F/U SGS and the level of the serological marker of salivary gland destruction after 131I therapy. Therefore, PG gland massage could alleviate salivary gland damage related to 131I therapy.

From the *Department of Nuclear Medicine, School of Medicine, Kyungpook National University

Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.

Received for publication February 13, 2019; revision accepted March 21, 2019.

Conflicts of interest and sources of funding: This research was supported by the Industry-Academy Collaborative Research in the form of an investigator-sponsored study through Kyungpook University and Sanofi-Genzyme Korea. The authors hereby attest and disclose that the study was funded by Sanofi-Genzyme Korea. However, any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of Sanofi-Genzyme Korea. The study was neither designed nor modified to reflect particular interests, and the authors whose names are listed in this study certify that they have no affiliations or involvement with Sanofi-Genzyme Korea and declare no conflicts of interests with the entity.

Correspondence to: Byeong-Cheol Ahn, MD, PhD, Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 50, Samduck 2-Ga, Jung Gu, Daegu, Republic of Korea 41944. E-mail:

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Online date: May 3, 2019

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