Recombinant human thyroid-stimulating hormone in radioiodine thyroid remnant ablation

Isr Med Assoc J. 2014 Feb;16(2):106-9.

Abstract

Background: To prevent the unwarranted effects of post-thyroidectomy hypothyroidism prior to radiodine (RAI) ablation, patients with well-differentiated thyroid cancer can currently undergo this treatment while in a euthyroid state. This is achieved with the use of recombinant human thyroid-stimulating hormone (rhTSH) injections prior to the ablation.

Objectives: To demonstrate the efficacy of rhTSH in radioiodine thyroid ablation in patients with differentiated thyroid cancer.

Methods: We conducted a retrospective study of patients who underwent total thyroidectomy for well-differentiated thyroid cancer with different levels of risk, treated with rhTSH prior to remnant ablation with radioiodine.

Results: Seventeen patients with thyroid cancer were studied and followed fora median of 25 months (range 8-49 months). Ablation (defined as stimulated thyroglobulin < 1 mg/ml and negative neck ultrasonography) was successful in 15 patients (88.2%). One of the patients was lost to follow-up.

Conclusions: The use of rhTSH with postoperative radioiodine ablation may be an efficient tool for sufficient thyroid remnant ablation, avoiding hypothyroidal state in the management of thyroid cancer patients.

MeSH terms

  • Ablation Techniques / methods*
  • Adult
  • Aged
  • Female
  • Humans
  • Hypothyroidism* / etiology
  • Hypothyroidism* / prevention & control
  • Iodine Radioisotopes / therapeutic use
  • Israel
  • Male
  • Middle Aged
  • Monitoring, Physiologic
  • Neoplasm Grading
  • Neoplasm Staging
  • Outcome Assessment, Health Care
  • Postoperative Complications / prevention & control*
  • Retrospective Studies
  • Thyroid Gland* / diagnostic imaging
  • Thyroid Gland* / surgery
  • Thyroid Neoplasms* / pathology
  • Thyroid Neoplasms* / therapy
  • Thyroidectomy / methods
  • Thyrotropin Alfa / therapeutic use*
  • Treatment Outcome
  • Ultrasonography

Substances

  • Iodine Radioisotopes
  • Thyrotropin Alfa