SynthesisEndocrine2026
Early versus delayed oral sialagogues for the prevention of salivary gland dysfunction after radioiodine therapy in differentiated thyroid cancer: a systematic review.
Synthesis in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
backgroundSalivary 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.
methodsA 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.
resultsThree 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%).
conclusionThis 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.
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