Radioiodine ablation with 1,850 MBq in association with rhTSH in patients with differentiated thyroid cancer

• Published in: Journal of endocrinological investigation Vol. 37; no. 8; pp. 709 - 714
• Main Authors: Tresoldi, Alberto S., Sburlati, Laura F., Rodari, Marcello, Schinkelshoek, Mink, Perrino, Michela, De Leo, Simone, Montefusco, Laura, Colombo, Paolo, Arosio, Maura, Lania, Andrea Gerardo Antonio, Fugazzola, Laura, Chiti, Arturo
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2014
• Subjects: Adenocarcinoma, Follicular - drug therapy; Adenocarcinoma, Follicular - pathology; Adenocarcinoma, Follicular - radiotherapy; Adenocarcinoma, Follicular - surgery; Adult; Carcinoma - drug therapy; Carcinoma - pathology; Carcinoma - radiotherapy; Carcinoma - surgery; Carcinoma, Papillary - drug therapy; Carcinoma, Papillary - pathology; Carcinoma, Papillary - radiotherapy; Carcinoma, Papillary - surgery; Carcinoma, Papillary, Follicular - drug therapy; Carcinoma, Papillary, Follicular - pathology; Carcinoma, Papillary, Follicular - radiotherapy; Carcinoma, Papillary, Follicular - surgery; Chemoradiotherapy, Adjuvant; Combined Modality Therapy; Endocrinology; Female; Humans; Iodine Radioisotopes - therapeutic use; Italy - epidemiology; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - prevention & control; Neoplasm Staging; Neoplasm, Residual - epidemiology; Neoplasm, Residual - prevention & control; Original Article; Radiopharmaceuticals - therapeutic use; Recombinant Proteins - therapeutic use; Retrospective Studies; Risk; Thyroid Cancer, Papillary; Thyroid Gland - drug effects; Thyroid Gland - pathology; Thyroid Gland - radiation effects; Thyroid Gland - surgery; Thyroid Neoplasms - drug therapy; Thyroid Neoplasms - pathology; Thyroid Neoplasms - radiotherapy; Thyroid Neoplasms - surgery; Thyroidectomy; Thyrotropin - genetics; Thyrotropin - therapeutic use; Whole Body Imaging; Radioiodine; RhTSH; Thyroid; Cancer
• ISSN: 1720-8386; 1720-8386
• DOI: 10.1007/s40618-014-0088-3

Purpose The aim of this study was to evaluate the efficacy of post-operative radioiodine ablation with 1,850 MBq after recombinant human thyrotropin (rhTSH) administration in patients with differentiated thyroid carcinoma (DTC). We also aimed to assess the prognostic role of several patient features on the outcome of ablation. Methods We retrospectively analyzed data from a total of 125 patients with DTC who underwent post-operative radioiodine ablation with 1,850 MBq of 131 I after preparation with rhTSH. One injection of 0.9 mg rhTSH was administered on each of two consecutive days; 131 I therapy was delivered 24 h after the last injection, followed by a post-therapy whole-body scan. Successful ablation was assessed 6–12 months later and defined as an rhTSH-stimulated serum thyroglobulin (Tg) level ≤1.0 ng/ml and a normal neck ultrasound. Results Patients were stratified according to the American Thyroid Association (ATA) Management Guidelines for Differentiated Thyroid Cancer. Successful ablation was achieved in 82.4 % of patients, with an ablation rate of 95.1 % in low-risk patients and 76.2 % in intermediate-risk patients. Analyzing the correlation between ablation outcome and patient characteristics, we found a statistically significant association between failure to ablate and class of risk based on ATA guidelines ( p  = 0.025) and a stimulated Tg value at ablation of above 5 ng/ml ( p  < 0.001). Conclusion The use of 1,850 MBq post-operative radioiodine thyroid remnant ablation in association with rhTSH is effective for low- and intermediate-risk patients. Moreover, in our study, we found a statistical correlation between failure to ablate and class of risk based on ATA guidelines for DTC and a stimulated Tg value at ablation.