Controle de xerostomia e hipossalivação em paciente pós iodoterapia – uma revisão integrativa e confecção de manual informativo para paciente

Abstract

INTRODUCTION: The incidence of thyroid cancer (TC) has been increasing globally due to early diagnosis. The treatment, which includes total thyroidectomy and radioactive iodine therapy (RIT), can lead to dysfunctions in the salivary glands, resulting in hyposalivation (HS) and xerostomia, which negatively impact the quality of life, oral health, and the social and psychological aspects of patients. OBJECTIVE: The objective of this study is to conduct an integrative literature review on xerostomia and HS following RIT, with the aim of developing playful and easily understandable written material in the form of a digital manual to assist patients with TC in managing the oral side effects of RIT, focusing on xerostomia and HS. METHOD: A survey of scientific articles was conducted in the research databases PUBMED/MEDLINE, LILACS, and GOOGLE SCHOLAR between March and October 2023 to comprehensively evaluate the various types of literature available on the subject. The information collected on thyroid cancer, RIT, xerostomia, and HS, which was presented in a compelling and corroborative manner across various literatures, as well as treatments discussed in clinical trials and systematic reviews, was summarized and adapted into lay language to facilitate the production of the patient manual. RESULTS: After applying exclusion criteria, 33 articles were selected, of which 12 were used as a basis for recommendations on management and 21 for foundational information regarding pathogenesis, epidemiology, and other descriptive points of the review. The integrative review identified that 33.1% of patients experienced xerostomia post-RIT, with 35.5% reporting severe xerostomia. Some solutions presented in the literature include the use of artificial saliva and oral lubricants, although their efficacy is limited. The findings of this review were translated into accessible language for the creation of a patient manual, which addresses relevant information about xerostomia, HS, and practices to minimize these side effects. CONCLUSION:The objectives of the study were achieved, obtaining sufficient theoretical support for the development of the proposed manual. However, further studies are necessary to address the demand for effective and long-lasting treatments for post-radiotherapy xerostomia.