Tang Charlene Yu Lin, Thang Sue Ping, Zaheer Sumbul, Kwan Chung Kong, Ng David Chee-Eng
Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
Duke-NUS Medical School, Singapore, Singapore.
Endocrine. 2020 Jul;69(1):126-132. doi: 10.1007/s12020-020-02238-z. Epub 2020 Feb 28.
To prepare for radioactive iodine therapy in post total thyroidectomy patients with well-differentiated thyroid cancer (WDTC), either thyroid hormone withdrawal (THW) or administration of recombinant human thyrotropin (rhTSH) can be performed.
Our objective is to compare quality of life (QoL) parameters using the SF-36v2 questionnaire (Short Form health survey) and a self-evaluated item, and the hypothyroid status using modified Billewicz scores in an Asian population undergoing either THW or rhTSH for remnant ablation or adjuvant treatment following total thyroidectomy for WDTC. We will also assess the proportion of patients achieving TSH level of >30 mU/L after 4 weeks of thyroid hormone withdrawal.
Patients in the rhTSH group were better in the QoL domains of physical functioning, role functioning/physical and bodily pain, while patients in THW group were better in mental health. This was however, not statistically significant. Modified Billewicz scores were higher in patients in THW group as compared with rhTSH group and statistically significant. A total of 96.3% of patients achieved TSH level >30 mU/L after 4 weeks of THW.
Clinical symptoms and signs of hypothyroidism as assessed with modified Billewicz scores were statistically significantly higher in the THW group. However, there was no statistically significant difference in QoL in the rhTSH group.
为接受全甲状腺切除的分化型甲状腺癌（WDTC）患者准备放射性碘治疗时，可采用甲状腺激素撤药（THW）或注射重组人促甲状腺素（rhTSH）的方法。
我们的目的是，使用SF-36v2问卷（简短健康调查问卷）和一项自我评估项目，比较在接受THW或rhTSH进行残留消融或辅助治疗的亚洲WDTC患者中，全甲状腺切除术后的生活质量（QoL）参数，以及使用改良的比勒维茨评分比较甲状腺功能减退状态。我们还将评估甲状腺激素撤药4周后促甲状腺激素（TSH）水平>30 mU/L的患者比例。
rhTSH组患者在身体功能、角色功能/身体和身体疼痛等QoL领域表现更好，而THW组患者在心理健康方面表现更好。然而，这在统计学上无显著差异。与rhTSH组相比，THW组患者的改良比勒维茨评分更高，且具有统计学意义。THW 4周后，共有96.3%的患者TSH水平>30 mU/L。
用改良比勒维茨评分评估的甲状腺功能减退的临床症状和体征在THW组中统计学上显著更高。然而，rhTSH组在QoL方面无统计学显著差异。
