Radioiodine ablation with 1,850 MBq in association with rhTSH in patients with differentiated thyroid cancer
- 180 Downloads
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.
We retrospectively analyzed data from a total of 125 patients with DTC who underwent post-operative radioiodine ablation with 1,850 MBq of 131I after preparation with rhTSH. One injection of 0.9 mg rhTSH was administered on each of two consecutive days; 131I 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.
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).
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.
KeywordsThyroid Cancer Radioiodine RhTSH
Conflict of interest
- 9.Schroeder PR, Haugen BR, Pacini F et al (2006) A comparison of short-term changes in health-related quality of life in thyroid carcinoma patients undergoing diagnostic evaluation with recombinant human thyrotropin compared with thyroid hormone withdrawal. J Clin Endocrinol Metab 91:878–884PubMedCrossRefGoogle Scholar
- 14.Molinaro E, Giani C, Agate L et al (2013) Patients with differentiated thyroid cancer who underwent radioiodine thyroid remnant ablation with low-activity 131I after either recombinant human TSH or thyroid hormone therapy withdrawal showed the same outcome after a 10-year follow-up. J Clin Endocrinol Metab 98:2693–2700PubMedCrossRefGoogle Scholar
- 24.Pacini F, Ladenson PW, Schlumberger M et al (2006) Radioiodine ablation of thyroid remnants after preparation with recombinant human thyrotropin in differentiated thyroid carcinoma: results of an international, randomized, controlled study. J Clin Endocrinol Metab 91:926–932PubMedCrossRefGoogle Scholar
- 26.Barbaro D, Boni G, Meucci G et al (2003) Radioiodine treatment with 30 mCi after recombinant human thyrotropin stimulation in thyroid cancer: effectiveness of postsurgical remnants ablation and possible role of iodine content in l-thyroxine in the outcome of ablation. J Clin Endocrinol Metab 88:4110–4115PubMedCrossRefGoogle Scholar
- 30.Kim MH, Ko SH, Bae JS et al (2012) Combination of initial stimulation thyroglobulins and staging system by revised ata guidelines can elaborately discriminate prognosis of patients with differentiated thyroid carcinoma after high-dose remnant ablation. Clin Nucl Med 37:1069–1074PubMedCrossRefGoogle Scholar