Wolfson Robert M, Rachinsky Irina, Morrison Deric, Driedger Al, Spaic Tamara, Van Uum Stan H M
Department of Diagnostic Imaging, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada N6A 5W9.
Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada N6A 4V2.
J Oncol. 2016;2016:6496750. doi: 10.1155/2016/6496750. Epub 2016 Feb 9.
Introduction. Recombinant human thyroid stimulating hormone (rhTSH) is approved for preparation of thyroid remnant ablation with radioactive iodine (RAI) in low risk patients with well differentiated thyroid cancer (DTC). We studied the safety and efficacy of rhTSH preparation for RAI treatment of thyroid cancer patients with nodal metastatic disease. Methods. A retrospective analysis was performed on 108 patients with histopathologically confirmed nodal metastatic DTC, treated with initial RAI between January 1, 2000, and December 31, 2007. Within this selected group, 31 and 42 patients were prepared for initial and all subsequent RAI treatments by either thyroid hormone withdrawal (THW) or rhTSH protocols and were followed up for at least 3 years. Results. The response to initial treatment, classified as excellent, acceptable, or incomplete, was not different between the rhTSH group (57%, 21%, and 21%, resp.) and the THW group (39%, 13%, and 48%, resp.; P = 0.052). There was no significant difference in the final clinical outcome between the groups. The rhTSH group received significantly fewer additional doses of RAI than the THW group (P = 0.03). Conclusion. In patients with nodal-positive DTC, preparation for RAI with rhTSH is a safe and efficacious alternative to THW protocol.
引言。重组人促甲状腺激素（rhTSH）已被批准用于低风险分化型甲状腺癌（DTC）患者放射性碘（RAI）甲状腺残余消融的准备工作。我们研究了rhTSH用于甲状腺癌伴淋巴结转移患者RAI治疗的安全性和有效性。方法。对2000年1月1日至2007年12月31日期间接受初次RAI治疗的108例经组织病理学证实为淋巴结转移的DTC患者进行回顾性分析。在该选定组中，31例和42例患者分别通过甲状腺激素撤减（THW）或rhTSH方案进行初次及所有后续RAI治疗的准备，并随访至少3年。结果。rhTSH组（分别为57%、21%和21%）和THW组（分别为39%、13%和48%；P = 0.052）对初始治疗的反应（分为优秀、可接受或不完全）没有差异。两组的最终临床结局没有显著差异。rhTSH组接受的额外RAI剂量明显少于THW组（P = 0.03）。结论。对于淋巴结阳性的DTC患者，rhTSH用于RAI准备是THW方案的一种安全有效的替代方法。
