Recombinant human thyroid-stimulating hormone to stimulate 131-I uptake for remnant ablation and adjuvant therapy Journal Article
| Authors: | Sabra, M. M.; Tuttle, R. M. |
| Article Title: | Recombinant human thyroid-stimulating hormone to stimulate 131-I uptake for remnant ablation and adjuvant therapy |
| Abstract: | To review the current literature with regard to the use of recombinant human thyroid stimulating hormone (rhTSH) as an adjunct to radioactive iodine (RAI) remnant ablation and adjuvant therapy. Literature review of clinical studies examining rhTSH and/or thyroid hormone withdrawal preparations for RAI remnant ablation. The primary endpoints evaluated were (1) effectiveness at ablating the thyroid bed as demonstrated by the lack of significant uptake in the thyroid bed on follow-up diagnostic imaging and (2) effectiveness in facilitating the adjuvant therapy function of RAI ablation as manifested by follow-up thyroid stimulating hormone (TSH)-stimulated serum thyroglobulin levels and clinical outcomes (recurrence rates, likelihood of having no evidence of disease at final follow-up). RAI remnant ablation can be successfully achieved using either traditional thyroid hormone withdrawal or recombinant human TSH preparation. While initial studies included primarily thyroid cancer patients at low risk of recurrence, more recent studies suggest that rhTSH can also be effectively used as preparation for RAI ablation in patients with an intermediate or high risk of recurrence. Furthermore, while early studies focused primarily on the endpoint of thyroid bed remnant ablation, more recent retrospective studies suggest that final clinical outcomes (recurrence rates, likelihood of achieving no evidence of disease status at final follow-up) over 5-10 years of follow-up are very similar with either method of preparation. rhTSH is an effective alternative to thyroid hormone withdrawal in preparation for RAI remnant ablation in patients without evidence of distant metastases who are at low, intermediate, or high risk of recurrence. |
| Keywords: | cancer survival; treatment outcome; unclassified drug; review; cancer recurrence; multimodality cancer therapy; adjuvant therapy; cancer adjuvant therapy; cancer patient; chemotherapy, adjuvant; combined modality therapy; cancer staging; recurrence risk; follow up; diagnostic imaging; distant metastasis; high risk patient; risk assessment; iodine 131; radioactive iodine; iodine radioisotopes; adjuvant chemotherapy; thyroidectomy; thyroid neoplasms; clinical effectiveness; thyroglobulin; thyroglobulin blood level; thyroid tumor; disease specific survival; recombinant thyrotropin; ablation therapy; recombinant human thyroid stimulating hormone; whole body scintiscanning; differentiated thyroid cancer; thyrotropin alfa |
| Journal Title: | Endocrine Practice |
| Volume: | 19 |
| Issue: | 1 |
| ISSN: | 1530-891X |
| Publisher: | American Association of Clinical Endocrinologists |
| Date Published: | 2013-01-01 |
| Start Page: | 149 |
| End Page: | 156 |
| Language: | English |
| DOI: | 10.4158/ep12278.ra |
| PUBMED: | 23186980 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 4 September 2013" - "Source: Scopus" |
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