Abstract
The primary treatment modalities for most patients with differentiated thyroid cancer include total thyroidectomy and radioactive iodine (RAI) remnant ablation (RRA; 1). The goal of RRA is to eliminate not only normal thyroid cells but also to destroy any residual microscopic thyroid carcinoma that may remain following total thyroidectomy and appropriate lymph node dissection. As reviewed in Chapters 14, 26, 32, and 88, RAI uptake into thyroid cells is enhanced by a lowiodine diet and thyrotropin (TSH) stimulation. For the past 40–50 yr, endogenous TSH production was stimulated by several weeks of thyroid hormone withdrawal prior to RAI dosing. However, thyroid hormone withdrawal often results in hypothyroid symptoms that are not well tolerated by many patients.
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References
Mazzaferri EL, Kloos RT. Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab 2001; 86:1447–1463.
Benua R, et al. An 18 year study of the use of beef thyrotropin to increase I-131 uptake in metastatic thyroid cancer. J Nucl Med 1964; 5:796–801.
Kirkpatrick CH, Meek JC, Rich RR. Mechanism of allergy to components of commercial bovine thyrotropin. J Allergy Clin Immunol 1973; 51:296–302.
Melmed S, Harada A, Hershman JM, Krishnamurthy GT, Bland WH. Neutralizing antibodies to bovine thyrotropin in immunized patients with thyroid cancer. J Clin Endocrinol Metab 1980; 51:358–363.
Robbins J. Pharmacology of bovine and human thyrotropin: an historical perspective. Thyroid 1999; 9:451–453.
Seidlin S, Oshry E, Yallow A. Spontaneous and experimentally induced uptake of radioactive iodine in metastases from thyroid carcinoma. J Clin Endocrinol Metab 1948; 8:423–425.
Woodmansee WW, Haugen BR. Uses for recombinant human TSH in patients with thyroid cancer and nodular goiter. Clin Endocrinol 2004; 61:163–173.
Robbins RJ, Robbins AK. Clinical review 156: Recombinant human thyrotropin and thyroid cancer management. J Clin Endocrinol Metab 2003; 88:1933–1938.
Perros P. Recombinant human thyroid-stimulating hormone (rhTSH) in the radioablation of well-differentiated thyroid cancer: preliminary therapeutic experience. 1999:30–34.
Berg G, et al. Radioiodine ablation and therapy in differentiated thyroid cancer under stimulation with recombinant human thyroid-stimulating hormone. J Endocrinol Invest 2002; 25:44–52.
Luster M, Lassmann M, Haenscheid H, et al. Use of recombinant human thyrotropin before radioiodine therapy in patients with advanced differentiated thyroid carcinoma. J Clin Endocrinol Metab 2000; 85:3640–3645.
Robbins RJ, et al. Radioiodine ablation of thyroid remnants after preparation with recombinant human thyrotropin. Thyroid 2001; 11:865–869.
Robbins RJ, et al. A retrospective review of the effectiveness of recombinant human TSH as a preparation for radioiodine thyroid remnant ablation. J Nucl Med 2002; 43:1482–1488.
Pacini F, et al. Ablation of thyroid residues with 30 mCi (131)I: a comparison in thyroid cancer patients prepared with recombinant human TSH or thyroid hormone withdrawal. J Clin Endocrinol Metab 2002; 87:4063–4068.
Barbaro D, et al. Radioiodine treatment with 30 mCi after recombinant human thyrotropin stimulation in thyroid cancer: effectiveness for postsurgical remnants ablation and possible role of iodine content in L-thyroxine in the outcome of ablation. J Clin Endocrinol Metab 2003; 88:4110–4115.
Ladenson PW, Pacini F, Schlumberger M, et al. Thyroid remnant ablation: A randomized comparison of thyrotropin alfa and thyroid hormone withdrawal. New Orleans, LA: 86th Annual Meeting, The Endocrine Society, June 16–19, 2004, Program S35-1, p. 45.
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© 2006 Humana Press Inc., Totowa, NJ
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Tuttle, R.M., Robbins, R.J. (2006). Thyroid Remnant Radioiodine Ablation with Recombinant Human Thyrotropin. In: Wartofsky, L., Van Nostrand, D. (eds) Thyroid Cancer. Humana Press. https://doi.org/10.1007/978-1-59259-995-0_27
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DOI: https://doi.org/10.1007/978-1-59259-995-0_27
Publisher Name: Humana Press
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