Clinical Outcomes After Radioiodine Therapy, According to the Method of Preparation by Recombinant TSH vs. Endogenous Hypothyroidism, in Thyroid Cancer Patients at Intermediate-High Risk of Recurrence
To effectively treat differentiated thyroid carcinoma (DTC) with radioiodine therapy (RAI), it is necessary to raise serum thyrotropin levels, either by thyroid hormone withdrawal (THW) or by administration of recombinant human TSH (rhTSH). The use of rh-TSH is controversial in DTC patients at inter...
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Published in | Frontiers in nuclear medicine Vol. 1; p. 785768 |
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Abstract | To effectively treat differentiated thyroid carcinoma (DTC) with radioiodine therapy (RAI), it is necessary to raise serum thyrotropin levels, either by thyroid hormone withdrawal (THW) or by administration of recombinant human TSH (rhTSH). The use of rh-TSH is controversial in DTC patients at intermediate to high risk of recurrence. Even more controversial is the question of whether is alters progression-free survival rates and overall survival in more aggressive patients.
The primary objective of this study was comparing clinical outcomes according to the method of preparation of RAI in intermediate to high DTC patients who presented progression of structural disease.
This retrospective study included 81 patients with initial intermediate to high DTC and progression of structural disease at the end of follow-up. In 21 patients, all RAI treatments were done with only rhTSH stimulation. In 11, RAI treatments were done either with thyroid hormone withdrawal (THW) or rhTSH. In 49 patients, all RAI treatments were done only THW.
After a median follow-up time of 83 months, there were no statistical differences in the clinical outcomes (status of structural disease at the end of the follow-up, death rate, overall survival curve, and progression-free survival curve).
Preparation for RAI therapy using either rhTSH stimulation or THW was associated with no inferiority in the clinical outcomes in progressive DTC patients at higher risk of recurrence. |
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AbstractList | Background:
To effectively treat differentiated thyroid carcinoma (DTC) with radioiodine therapy (RAI), it is necessary to raise serum thyrotropin levels, either by thyroid hormone withdrawal (THW) or by administration of recombinant human TSH (rhTSH). The use of rh-TSH is controversial in DTC patients at intermediate to high risk of recurrence. Even more controversial is the question of whether is alters progression-free survival rates and overall survival in more aggressive patients.
Objective:
The primary objective of this study was comparing clinical outcomes according to the method of preparation of RAI in intermediate to high DTC patients who presented progression of structural disease.
Methods:
This retrospective study included 81 patients with initial intermediate to high DTC and progression of structural disease at the end of follow-up. In 21 patients, all RAI treatments were done with only rhTSH stimulation. In 11, RAI treatments were done either with thyroid hormone withdrawal (THW) or rhTSH. In 49 patients, all RAI treatments were done only THW.
Results:
After a median follow-up time of 83 months, there were no statistical differences in the clinical outcomes (status of structural disease at the end of the follow-up, death rate, overall survival curve, and progression-free survival curve).
Conclusions:
Preparation for RAI therapy using either rhTSH stimulation or THW was associated with no inferiority in the clinical outcomes in progressive DTC patients at higher risk of recurrence. Background: To effectively treat differentiated thyroid carcinoma (DTC) with radioiodine therapy (RAI), it is necessary to raise serum thyrotropin levels, either by thyroid hormone withdrawal (THW) or by administration of recombinant human TSH (rhTSH). The use of rh-TSH is controversial in DTC patients at intermediate to high risk of recurrence. Even more controversial is the question of whether is alters progression-free survival rates and overall survival in more aggressive patients. Objective: The primary objective of this study was comparing clinical outcomes according to the method of preparation of RAI in intermediate to high DTC patients who presented progression of structural disease. Methods: This retrospective study included 81 patients with initial intermediate to high DTC and progression of structural disease at the end of follow-up. In 21 patients, all RAI treatments were done with only rhTSH stimulation. In 11, RAI treatments were done either with thyroid hormone withdrawal (THW) or rhTSH. In 49 patients, all RAI treatments were done only THW. Results: After a median follow-up time of 83 months, there were no statistical differences in the clinical outcomes (status of structural disease at the end of the follow-up, death rate, overall survival curve, and progression-free survival curve). Conclusions: Preparation for RAI therapy using either rhTSH stimulation or THW was associated with no inferiority in the clinical outcomes in progressive DTC patients at higher risk of recurrence.Background: To effectively treat differentiated thyroid carcinoma (DTC) with radioiodine therapy (RAI), it is necessary to raise serum thyrotropin levels, either by thyroid hormone withdrawal (THW) or by administration of recombinant human TSH (rhTSH). The use of rh-TSH is controversial in DTC patients at intermediate to high risk of recurrence. Even more controversial is the question of whether is alters progression-free survival rates and overall survival in more aggressive patients. Objective: The primary objective of this study was comparing clinical outcomes according to the method of preparation of RAI in intermediate to high DTC patients who presented progression of structural disease. Methods: This retrospective study included 81 patients with initial intermediate to high DTC and progression of structural disease at the end of follow-up. In 21 patients, all RAI treatments were done with only rhTSH stimulation. In 11, RAI treatments were done either with thyroid hormone withdrawal (THW) or rhTSH. In 49 patients, all RAI treatments were done only THW. Results: After a median follow-up time of 83 months, there were no statistical differences in the clinical outcomes (status of structural disease at the end of the follow-up, death rate, overall survival curve, and progression-free survival curve). Conclusions: Preparation for RAI therapy using either rhTSH stimulation or THW was associated with no inferiority in the clinical outcomes in progressive DTC patients at higher risk of recurrence. To effectively treat differentiated thyroid carcinoma (DTC) with radioiodine therapy (RAI), it is necessary to raise serum thyrotropin levels, either by thyroid hormone withdrawal (THW) or by administration of recombinant human TSH (rhTSH). The use of rh-TSH is controversial in DTC patients at intermediate to high risk of recurrence. Even more controversial is the question of whether is alters progression-free survival rates and overall survival in more aggressive patients. The primary objective of this study was comparing clinical outcomes according to the method of preparation of RAI in intermediate to high DTC patients who presented progression of structural disease. This retrospective study included 81 patients with initial intermediate to high DTC and progression of structural disease at the end of follow-up. In 21 patients, all RAI treatments were done with only rhTSH stimulation. In 11, RAI treatments were done either with thyroid hormone withdrawal (THW) or rhTSH. In 49 patients, all RAI treatments were done only THW. After a median follow-up time of 83 months, there were no statistical differences in the clinical outcomes (status of structural disease at the end of the follow-up, death rate, overall survival curve, and progression-free survival curve). Preparation for RAI therapy using either rhTSH stimulation or THW was associated with no inferiority in the clinical outcomes in progressive DTC patients at higher risk of recurrence. |
Author | Andrade, Fernanda Accioly Fernanda, Paula Vaisman, Fernanda Higuchi, Cynara Rena Salmont Corbo, Rossana Vaisman, Mario Jurnior, Paulo Alonso Bulzico, Daniel |
AuthorAffiliation | 1 Endocrinology Service, Instituto Nacional do Cancer do Rio de Janeiro , Rio de Janeiro , Brazil 2 Endocrinology Service, Faculdade de Medicina, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil |
AuthorAffiliation_xml | – name: 2 Endocrinology Service, Faculdade de Medicina, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil – name: 1 Endocrinology Service, Instituto Nacional do Cancer do Rio de Janeiro , Rio de Janeiro , Brazil |
Author_xml | – sequence: 1 givenname: Cynara Rena Salmont surname: Higuchi fullname: Higuchi, Cynara Rena Salmont organization: Endocrinology Service, Instituto Nacional do Cancer do Rio de Janeiro, Rio de Janeiro, Brazil – sequence: 2 givenname: Paula surname: Fernanda fullname: Fernanda, Paula organization: Endocrinology Service, Instituto Nacional do Cancer do Rio de Janeiro, Rio de Janeiro, Brazil – sequence: 3 givenname: Paulo Alonso surname: Jurnior fullname: Jurnior, Paulo Alonso organization: Endocrinology Service, Instituto Nacional do Cancer do Rio de Janeiro, Rio de Janeiro, Brazil – sequence: 4 givenname: Fernanda Accioly surname: Andrade fullname: Andrade, Fernanda Accioly organization: Endocrinology Service, Instituto Nacional do Cancer do Rio de Janeiro, Rio de Janeiro, Brazil – sequence: 5 givenname: Rossana surname: Corbo fullname: Corbo, Rossana organization: Endocrinology Service, Instituto Nacional do Cancer do Rio de Janeiro, Rio de Janeiro, Brazil – sequence: 6 givenname: Mario surname: Vaisman fullname: Vaisman, Mario organization: Endocrinology Service, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil – sequence: 7 givenname: Fernanda surname: Vaisman fullname: Vaisman, Fernanda organization: Endocrinology Service, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil – sequence: 8 givenname: Daniel surname: Bulzico fullname: Bulzico, Daniel organization: Endocrinology Service, Instituto Nacional do Cancer do Rio de Janeiro, Rio de Janeiro, Brazil |
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Cites_doi | 10.1089/thy.2012.0183 10.1016/j.radonc.2013.12.018 10.1055/s-0029-1225350 10.4158/EP12244.RA 10.1089/thy.2011.0235 10.1089/thy.2015.0020 10.1089/thy.2013.0157 10.1210/jc.2011-0305 10.1089/thy.2006.16.1121 10.1002/14651858.CD008302 10.1089/thy.2009.0401 |
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Copyright | Copyright © 2021 Higuchi, Fernanda, Jurnior, Andrade, Corbo, Vaisman, Vaisman and Bulzico. Copyright © 2021 Higuchi, Fernanda, Jurnior, Andrade, Corbo, Vaisman, Vaisman and Bulzico. 2021 Higuchi, Fernanda, Jurnior, Andrade, Corbo, Vaisman, Vaisman and Bulzico |
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Keywords | recombinant human TSH thyroid cancer radioiodine intermediate to high risk ablation |
Language | English |
License | Copyright © 2021 Higuchi, Fernanda, Jurnior, Andrade, Corbo, Vaisman, Vaisman and Bulzico. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Edited by: Petra Petranović Ovčariček, University Hospital Center Sestre Milosrdnice, Croatia This article was submitted to Radionuclide Therapy, a section of the journal Frontiers in Nuclear Medicine Reviewed by: Gaetano Paone, Cantonal Hospital Authority, Switzerland; Alfredo Campenni', University of Messina, Italy |
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References | Tu (B8) 2014; 110 Tuttle (B11) 2010; 20 Haugen (B1) 2016; 26 Robbins (B7) 2006; 16 Klubo-Gwiezdzinska (B6) 2012; 22 Ma (B9) 2010; 2010 Tala (B3) 2011; 96 Hugo (B4) 2012; 22 Bartenstein (B5) 2014; 24 Klubo-Gwiezdzinska (B2) 2013; 19 Freudenberg (B10) 2010; 118 |
References_xml | – volume: 22 start-page: 1007 year: 2012 ident: B4 article-title: Recombinant human thyroid stimulating hormone-assisted radioactive iodine remnant ablation in thyroid cancer patients at intermediate to high risk of recorrence publication-title: Thyroid. doi: 10.1089/thy.2012.0183 contributor: fullname: Hugo – volume: 110 start-page: 25 year: 2014 ident: B8 article-title: Recombinant human thyrotropin-aided versus thyroid hormone withdrawal-aided radioiodine treatment for differentiated thyroid câncer after total thyroidectomy: a meta-analysis publication-title: Radiother Oncol. doi: 10.1016/j.radonc.2013.12.018 contributor: fullname: Tu – volume: 118 start-page: 393 year: 2010 ident: B10 article-title: Thyroid remnant dose: 124I-PET/CT dosimetric comparison of rhTSH versus thyroid hormone withholding before radioiodine remnant ablation in differentiated thyroid cancer publication-title: Exp Clin Endocrinol Diabetes. doi: 10.1055/s-0029-1225350 contributor: fullname: Freudenberg – volume: 19 start-page: 139 year: 2013 ident: B2 article-title: Potential use of recombinant human thyrotropin in the treatment of distant metastases in patients with differentiated thyroid cancer publication-title: Endocr Pract. doi: 10.4158/EP12244.RA contributor: fullname: Klubo-Gwiezdzinska – volume: 22 start-page: 310 year: 2012 ident: B6 article-title: Treatment of metastatic thyroid cancer: relative efficacy and side effect profile of preparation by thyroid hormone withdrawal versus recombinant human thyrotropin publication-title: Thyroid. doi: 10.1089/thy.2011.0235 contributor: fullname: Klubo-Gwiezdzinska – volume: 26 start-page: 1 year: 2016 ident: B1 article-title: 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer publication-title: Thyroid doi: 10.1089/thy.2015.0020 contributor: fullname: Haugen – volume: 24 start-page: 480 year: 2014 ident: B5 article-title: High-risk patients with differentiated thyroid cancer T4 primary tumors achieve remnant ablation equally well using rhTSH or thyroid hormone withdrawal publication-title: Thyroid. doi: 10.1089/thy.2013.0157 contributor: fullname: Bartenstein – volume: 96 start-page: 2105 year: 2011 ident: B3 article-title: Five-year survival is similar thyroid cancer patients with metastases prepared for radioactive iodine therapy with either thyroid hormone withdrawal or recombinant human TSH publication-title: J Clin Endocrinol Metabol. doi: 10.1210/jc.2011-0305 contributor: fullname: Tala – volume: 16 start-page: 1121 year: 2006 ident: B7 article-title: U.S. and Canadian Thyrogen Compassionate Use Program Investigator Group. Recombinant human thyrotropin-assisted radioiodine therapy for patients with metastatic thyroid cancer who could not elevate endogenous thyrotropin or be withdrawn from thyroxine publication-title: Thyroid. doi: 10.1089/thy.2006.16.1121 contributor: fullname: Robbins – volume: 2010 start-page: CD008302 year: 2010 ident: B9 article-title: Recombinant human thyrotropin (rhTSH) aided radioiodine treatment for residual or metastatic differentiated thyroid cancer publication-title: Cochrane Database Syst Rev. doi: 10.1002/14651858.CD008302 contributor: fullname: Ma – volume: 20 start-page: 257 year: 2010 ident: B11 article-title: Radioactive iodine administered for thyroid remnant ablation following recombinant human thyroid stimulating hormone preparation also has an important adjuvant therapy function publication-title: Thyroid. doi: 10.1089/thy.2009.0401 contributor: fullname: Tuttle |
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Snippet | To effectively treat differentiated thyroid carcinoma (DTC) with radioiodine therapy (RAI), it is necessary to raise serum thyrotropin levels, either by... Background: To effectively treat differentiated thyroid carcinoma (DTC) with radioiodine therapy (RAI), it is necessary to raise serum thyrotropin levels,... Background: To effectively treat differentiated thyroid carcinoma (DTC) with radioiodine therapy (RAI), it is necessary to raise serum thyrotropin levels,... |
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Title | Clinical Outcomes After Radioiodine Therapy, According to the Method of Preparation by Recombinant TSH vs. Endogenous Hypothyroidism, in Thyroid Cancer Patients at Intermediate-High Risk of Recurrence |
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