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rhTSH is as effective as thyroid hormone withdrawal protocol for radioiodine ablation. Long-term follow-up

¹ Nuclear Medicine, LHSC, London, Ontario, Canada

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Objectives: To retrospectively evaluate persistence/recurrence rates during median follow up 4.2 years (range 3-8.7 years) in patients who were prepared for radioiodine ablation by rhTSH (Thyrogen) or by thyroid hormone withdrawal (Hypo).

Methods: A web-based Thyroid cancer database was used to identify the patients. All patients with follow up longer than 3 years were included, 50 prepared with rhTSH and 126 were Hypo. Successful radioiodine ablation was defined as stimulated thyroglobulin (S-Tg) <1 ng/ml at 6-12 months post ablation.

Results: Based on the criteria listed above, successful ablation was achieved in 38/50 (76%) and 86/126 (68.3%) patients, rhTSH and Hypo groups respectively. 10 and 23 patients received additional 131I treatments and 3 and 6 had neck dissections. At the time of final analysis, 9/50 from rhTSH group (3 with persistent but stable, one- progression, one- recurrent disease, one –persistent but improving disease) and in the Hypo group, 14/126 (8 with stable disease, 3- persistent but improving, 2 with disease progression and one- with recurrent disease) had active disease with measurable S-Tg levels.

Conclusions: rhTSH and thyroid hormone withdrawal protocols have comparable rates of successful thyroid remnant ablation as well as disease recurrent rates after median follow up of 4.2 years. Since hypothyroidism has a significant negative impact on short-term as well as long-term quality of life of thyroid cancer patients, rhTSH protocol is preferable over thyroid hormone withdrawal in the majority of patients.

Research Support: Genzyme Corporation supports the database maintenance.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Rachinsky, I. Articles by Warnock, L. PubMed Articles by Rachinsky, I. Articles by Warnock, L.