Artificial Tears to Prevent Nasolacrimal Duct Obstruction in Patients Treated with Radioactive Iodine for Thyroid Cancer

Purpose

The association of radioiodine therapy for the treatment of thyroid cancer with nasolacrimal duct obstruction has been well documented in the medical literature. Prior case reports have documented radioactive iodine detection in the tears of patients following radioiodine therapy. It is possible that radioactive uptake by the cells in the lacrimal sac and nasolacrimal duct lead to inflammation, fibrosis, and obstruction of the tear duct over time. A recent study has shown that the administration of artificial tears decreases the level of detectable radioiodine in the tears of patients undergoing radioiodine therapy for thyroid cancer. The purpose of this study will be to assess whether administering tears after radioactive iodine therapy for thyroid cancer decreases the incidence of nasolacrimal duct obstruction in the two years following radioactive iodine treatment.

Conditions

  • Nasolacrimal Duct Obstruction
  • Thyroid Cancer

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  1. Radio-iodine therapy for thyroid cancer 2. Radioiodine therapy ≥150 mCi 3. Age 18 or older

Exclusion Criteria

  1. Use of eye drops, other than artificial tears 2. History of periocular trauma with tear duct involvement/lacrimal gland trauma 3. History of lacrimal drainage disease: canaliculitis, dacryocystitis 4. Prior radiotherapy 5. Current or prior use of chemotherapy drugs (i.e. 5-fluorouracil, docetaxel) 6. Medical conditions that predispose to NLD stenosis (i.e. sarcoidosis, granulomatosis with polyangiitis, chronic lymphocytic leukemia) 7. Nasolacrimal duct obstruction at baseline

Study Design

Phase
Phase 3
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Prevention
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Experimental Arm (Artificial Tears)
Participants in this arm will receive artificial tears to be administered in the 4 days immediately following radioactive iodine therapy. The schedule of administration will be as follows: Day 1 (day of radioactive iodine therapy): Every 15 minutes for 2 hours, then every 30 minutes for at least 4 hours or until bedtime at night Day 2: Once every 1 hour for 12 hours Day 3: Four times (approximately morning, lunch, dinner, and evening) Day 4: Two times (morning and evening)
  • Drug: Artificial Tears Methylcellulose
    Participants will self-administer the artificial tears according to the schedule.
No Intervention
No Intervention (No Artificial Tears)
Participants in this arm will not administer artificial tears in the 4 days immediately following radioactive iodine therapy.

Recruiting Locations

Vanderbilt University Medical Center
Nashville, Tennessee 37232
Contact:
Rachel Sobel, MD
4152796578
rachel.k.sobel@vumc.org

More Details

Status
Recruiting
Sponsor
Vanderbilt University Medical Center

Study Contact

Marybeth Carter
615-936-1639
marybeth.l.carter@vumc.org