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Na, Shin, Kang, Son, Kim, and Kim: A Retrospective Review of the Effectiveness of Recombinant Human TSH-Aided Radioiodine Treatment of Differentiated Thyroid Carcinoma
Original Article
Journal of Korean Society of Endocrinology

Journal of Korean Society of Endocrinology 2006; 21(4): 274-280.

Published online: 20 August 2006

DOI: https://doi.org/10.3803/jkes.2006.21.4.274

A Retrospective Review of the Effectiveness of Recombinant Human TSH-Aided Radioiodine Treatment of Differentiated Thyroid Carcinoma

Min Ah Na, Sun Hae Shin, Yang Ho Kang, Seok Man Son, In Joo Kim, Yong Ki Kim

Department of Internal Medicine, School of Medicine, Pusan National University, Korea.

Received 3 February 2006       Accepted 13 April 2006

Copyright © 2006 Korean Endocrine Society

Abstract

Background

The aim of the study was to evaluate the biochemical effects of recombinant human thyroid stimulating hormone (rhTSH) as an adjunct to radioiodine (RI) treatment of a differentiated thyroid carcinoma (DTC). We retrospectively reviewed the clinical response rates of DTC patients treated with RI after thyroid hormone withdrawal and compared with those after rhTSH stimulation.

Method

We included the patients treated with RI for locally recurrent DTC from February 1, 2002 to August 31, 2005 and followed with diagnostic studies at our hospital. Forty totally (or near totally) thyroidectomized adults were included in this study. Nine patients underwent RI treatment after rhTSH stimulation while euthyoid on L-thyroxine (LT4), and 31 patients were treated with RI after thyroid hormone withdrawal. The clinical response was defined as > 25% decrease in serum thyroglobulin (Tg) level on LT4 3 months after the RI treatment.

Results

In each group, serum Tg levels were significantly decreased 3 months after the RI treatment. And we found that 77.8 and 71.0% of those prepared by rhTSH and LT4 withdrawal, respectively, had clinical responses 3 months after the RI treatment by our criteria and there was no significant difference in response rates between two groups (P = 0.238).

Conclusions

Given the biases that exist in retrospective studies, at the current time we cannot recommend the routine use of rhTSH to prepare RI treatment of DTC. However, our study provided preliminary evidence that rhTSH effectively aided RI treatment of DTC at least to an equivalent degree as LT4 withdrawal.

Keywords: Differentiated thyroid carcinoma, Radioiodine treatment, Recombinant human thyroid stimulating hormone

Figures and Tables

Fig. 1
Serum thyroid stimulating hormone (TSH) response in patients who underwent radioiodine (RI) treatment. A. recombinant human thyroid stimulating hormone group. B. T4 withdrawal group.
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Fig. 2
Serum thyroglobulin (Tg) response in patients who underwent radioiodine (RI) treatment. A. recombinant human thyroid stimulating hormone group. B. T4 withdrawal group.
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Table 1
Basal characteristics
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*Mean ± SD.

RI, radioiodine; rhTSH, recombinant human thyroid stimulating hormone.

Table 2
Examination schema in the follow up of patients treated with rhTSH
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i.m., intramuscular injection; RI, radioiodine; rhTSH, recombinant human thyroid stimulating hormone; Tg, thyroglobin; WBS, whole body scan.

Table 3
Overall outcome of radioiodine treatment
jkse-21-274-i003

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