Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.
Sci Rep. 2019 Apr 3;9(1):5570. doi: 10.1038/s41598-019-42083-3.
We aimed to determine whether recombinant human thyrotropin (rhTSH) plus 3.7 GBq could replace thyroid hormone withdrawal (THW) plus 5.55 GBq for adjuvant radioactive iodine (RAI) therapy in differentiated thyroid cancer (DTC) patients with T4 or N1b disease. This study was a retrospective study comparing ablation success rate, response to initial therapy, and recurrence-free survival (RFS) of patients with rhTSH plus 3.7 GBq versus those with THW plus 5.55 GBq in 253 DTC patients with T4 or N1b disease. There were no differences in the TSH-stimulated thyroglobulin level, rate of incomplete response after initial treatment, or the RFS between the two treatment strategies. However, thyroid bed uptake on follow-up diagnostic RAI whole-body scanning (WBS) was more frequently observed in the group treated with rhTSH plus 3.7 GBq than in the group with THW plus 5.55 GBq. Adjuvant RAI therapy with rhTSH plus 3.7 GBq had comparable results in the absence of persistent tumor, compared with that with THW plus 5.55 GBq. Although thyroid bed uptake was more frequently observed, rhTSH plus 3.7 GBq may be used instead of THW plus 5.55 GBq for adjuvant RAI therapy in patients with T4 or N1b disease.
我们旨在确定重组人促甲状腺激素（rhTSH）加 3.7GBq 是否可以替代甲状腺激素抑制（THW）加 5.55GBq 用于 T4 或 N1b 疾病的分化型甲状腺癌（DTC）患者的辅助放射性碘（RAI）治疗。这项研究是一项回顾性研究，比较了 rhTSH 加 3.7GBq 与 THW 加 5.55GBq 治疗 253 例 T4 或 N1b 疾病的 DTC 患者的消融成功率、初始治疗反应和无复发生存率（RFS）。在 TSH 刺激的甲状腺球蛋白水平、初始治疗后不完全反应的发生率以及两种治疗策略的 RFS 方面，两组之间没有差异。然而，在 rhTSH 加 3.7GBq 治疗组中，随访诊断性 RAI 全身扫描（WBS）中甲状腺床摄取的频率比 THW 加 5.55GBq 治疗组更频繁。在没有持续性肿瘤的情况下，rhTSH 加 3.7GBq 辅助 RAI 治疗的结果与 THW 加 5.55GBq 相似。尽管更频繁地观察到甲状腺床摄取，但 rhTSH 加 3.7GBq 可能可以替代 THW 加 5.55GBq 用于 T4 或 N1b 疾病患者的辅助 RAI 治疗。
