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Radioiodine ablation and therapy in differentiated thyroid cancer under stimulation with recombinant human thyroid-stimulating hormone
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- Berg, Gertrud, 1944 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för särskilda specialiteter, Avdelningen för onkologi,Institute of Selected Clinical Sciences, Department of Oncology
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- Lindstedt, Göran, 1937 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för laboratoriemedicin, Avdelningen för klinisk kemi/transfusionsmedicin,Institute of Laboratory Medicine, Dept of Clinical Chemistry/Transfusion Medicine
- Suurküla, Mark (author)
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- Jansson, S. (author)
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- (creator_code:org_t)
- 2002
- 2002
- English.
- In: J Endocrinol Invest. - 0391-4097. ; 25:1, s. 44-52
- Journal article (peer-reviewed)
Abstract
Subject headings
Close
- We investigated whether recombinant human TSH (rhTSH) safely and effectively induces uptake of high-dose 131-iodine (131I) to ablate thyroid remnant or treat disease, in patients with well-differentiated thyroid carcinoma. Eleven consecutive patients unable to tolerate thyroid hormone withdrawal received one im injection of 0.9 mg rhTSH on 2 consecutive days before receiving 4000 MBq (approximately 108 mCi) radioiodine orally. Eight patients received one, and 3 patients 2 courses. Our series comprised 7 women and 4 men (mean age, 78 yr, range: 56-87 yr). Ten patients had undergone total or near-total thyroidectomy up to 19 yr earlier. rhTSH-stimulated single course radioiodine with the intention to ablate thyroid remnant was performed in 3 patients, with following estimation of radioiodine uptake and TG measurements. Of another 8 patients given this treatment palliatively, 5 had radiological, clinical and/or laboratory response, including: 80% decreased pathological uptake between treatment courses; pronounced decrease in bone pain; diminished symptoms; improved physical condition and quality of life; lower serum TG concentration; and/or normalization of TG recovery test. Two patients with small lung metastases on computed tomography had no detectable radioiodine uptake or other response; they also lacked uptake after withdrawal-stimulated radioiodine treatment. Despite being elderly and frail, patients generally tolerated treatment well; rhTSH caused nausea in one patient and transiently increased pain in bone and soft tissue lesions in another. We conclude that rhTSH-stimulated high-dose radioiodine for remnant ablation or tumor treatment is safe, feasible and seemingly effective, enhancing quality of life and offering reasonable palliation in patients with advanced disease.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- Aged
- Aged
- 80 and over
- Combined Modality Therapy
- Dose-Response Relationship
- Drug
- Female
- Humans
- Iodine Radioisotopes/administration & dosage/adverse effects/*therapeutic
- use
- Lung Neoplasms/drug therapy/radiotherapy/secondary
- Male
- Middle Aged
- Palliative Care
- Recombinant Proteins/therapeutic use
- Safety
- Thyroglobulin/biosynthesis
- Thyroid Neoplasms/*drug therapy/metabolism/*radiotherapy
- Thyrotropin/adverse effects/*therapeutic use
- Treatment Failure
- Treatment Outcome
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- ref (subject category)
- art (subject category)
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