The Effectiveness of Recombinant Human Thyroid-stimulating Hormone Versus Thyroid Hormone Withdrawal Prior to Radioiodine Remnant Ablation in Thyroid Cancer: a Meta-analysis of Randomized Controlled Trials

Overview

Journal J Korean Med Sci

Specialty General Medicine

Date 2014 Jun 17

PMID 24932083

Citations 6

Authors

Kyoungjune Pak

Gi Jeong Cheon

Keon Wook Kang

Seong-Jang Kim

In-Joo Kim

E Edmund Kim

Dong Soo Lee

June-Key Chung

Affiliations

Soon will be listed here.

Abstract

We evaluated the efficacy of recombinant human thyroid-stimulating hormone (rhTSH) versus thyroid hormone withdrawal (THW) prior to radioiodine remnant ablation (RRA) in thyroid cancer. A systematic search of MEDLINE, EMBASE, the Cochrane Library, and SCOPUS was performed. Randomized controlled trials that compared ablation success between rhTSH and THW at 6 to 12 months following RRA were included in this study. Six trials with a total of 1,660 patients were included. When ablation success was defined as a thyroglobulin (Tg) cutoff of 1 ng/mL (risk ratio, 0.99; 95% confidence interval, 0.96-1.03) or a Tg cutoff of 1 ng/mL plus imaging modality (RR 0.97; 0.90-1.05), the results of rhTSH and THW were similar. There were no significant differences when ablation success was defined as a Tg cutoff of 2 ng/mL (RR 1.03; 0.95-1.11) or a Tg cutoff of 2 ng/mL plus imaging modality (RR 1.02; 0.95-1.09). When a negative (131)I-whole body scan was used solely as the definition of ablation success, the effects of rhTSH and THW were not significantly different (RR 0.97; 0.93-1.02). Therefore, ablation success rates are comparable when RRA is prepared by either rhTSH or THW.

Citing Articles

Initial Evaluation of Therapy Response after Adjuvant Radioiodine Therapy in Patients with Early-Stage Papillary Thyroid Cancer-Does Time Matter?.

Grawe F, Cramm Y, Fabritius M, Ruebenthaler J, Koehler V, Ilhan H Cancers (Basel). 2022; 14(3).

PMID: 35158769 PMC: 8833817. DOI: 10.3390/cancers14030501.

Comparison of day 3 and day 5 thyroglobulin results after thyrogen injection in differentiated thyroid cancer patients.

Sager S, Hatipoglu E, Gunes B, Asa S, Uslu L, Sonmezoglu K Ther Adv Endocrinol Metab. 2018; 9(6):177-183.

PMID: 29854387 PMC: 5956637. DOI: 10.1177/2042018818770108.

Circulating thyroid stimulating hormone receptor messenger RNA and differentiated thyroid cancer: A diagnostic meta-analysis.

Zhang Z, Chen Q, Kong C, Li Z, Wang L Oncotarget. 2016; 8(4):6623-6629.

PMID: 28036261 PMC: 5351657. DOI: 10.18632/oncotarget.14251.

2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.

Haugen B, Alexander E, Bible K, Doherty G, Mandel S, Nikiforov Y Thyroid. 2015; 26(1):1-133.

PMID: 26462967 PMC: 4739132. DOI: 10.1089/thy.2015.0020.

Does (131)I Radioactivity Interfere with Thyroglobulin Measurement in Patients Undergoing Radioactive Iodine Therapy with Recombinant Human TSH?.

Park S, Bang J, Lee H, Kim S Nucl Med Mol Imaging. 2015; 49(2):122-6.

PMID: 26085857 PMC: 4463868. DOI: 10.1007/s13139-014-0317-x.

References

Schlumberger M, Catargi B, Borget I, Deandreis D, Zerdoud S, Bridji B . Strategies of radioiodine ablation in patients with low-risk thyroid cancer. N Engl J Med. 2012; 366(18):1663-73. DOI: 10.1056/NEJMoa1108586. View

Molinaro E, Giani C, Agate L, Biagini A, Pieruzzi L, Bianchi F . Patients with differentiated thyroid cancer who underwent radioiodine thyroid remnant ablation with low-activity ¹³¹I after either recombinant human TSH or thyroid hormone therapy withdrawal showed the same outcome after a 10-year follow-up. J Clin Endocrinol Metab. 2013; 98(7):2693-700. DOI: 10.1210/jc.2012-4137. View

Andros G, Wollman S . Autoradiographic localization of radioiodide in the thyroid gland of the mouse. Am J Physiol. 1967; 213(1):198-208. DOI: 10.1152/ajplegacy.1967.213.1.198. View

Kogai T, Taki K, Brent G . Enhancement of sodium/iodide symporter expression in thyroid and breast cancer. Endocr Relat Cancer. 2006; 13(3):797-826. DOI: 10.1677/erc.1.01143. View

Dohan O, De la Vieja A, Paroder V, Riedel C, Artani M, Reed M . The sodium/iodide Symporter (NIS): characterization, regulation, and medical significance. Endocr Rev. 2003; 24(1):48-77. DOI: 10.1210/er.2001-0029. View

Borget I, Corone C, Nocaudie M, Allyn M, Iacobelli S, Schlumberger M . Sick leave for follow-up control in thyroid cancer patients: comparison between stimulation with Thyrogen and thyroid hormone withdrawal. Eur J Endocrinol. 2007; 156(5):531-8. DOI: 10.1530/EJE-06-0724. View

Siegel R, DeSantis C, Virgo K, Stein K, Mariotto A, Smith T . Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin. 2012; 62(4):220-41. DOI: 10.3322/caac.21149. View

Egger M, Davey Smith G, Schneider M, Minder C . Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997; 315(7109):629-34. PMC: 2127453. DOI: 10.1136/bmj.315.7109.629. View

Ma C, Xie J, Liu W, Wang G, Zuo S, Wang X . Recombinant human thyrotropin (rhTSH) aided radioiodine treatment for residual or metastatic differentiated thyroid cancer. Cochrane Database Syst Rev. 2010; (11):CD008302. PMC: 6718234. DOI: 10.1002/14651858.CD008302.pub2. View

10.

Higgins J, Altman D, Gotzsche P, Juni P, Moher D, Oxman A . The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011; 343:d5928. PMC: 3196245. DOI: 10.1136/bmj.d5928. View

11.

Mernagh P, Campbell S, Dietlein M, Luster M, Mazzaferri E, Weston A . Cost-effectiveness of using recombinant human TSH prior to radioiodine ablation for thyroid cancer, compared with treating patients in a hypothyroid state: the German perspective. Eur J Endocrinol. 2006; 155(3):405-14. DOI: 10.1530/eje.1.02223. View

12.

Barbaro D, Boni G, Meucci G, Simi U, Lapi P, Orsini P . Recombinant human thyroid-stimulating hormone is effective for radioiodine ablation of post-surgical thyroid remnants. Nucl Med Commun. 2006; 27(8):627-32. DOI: 10.1097/00006231-200608000-00005. View

13.

Chianelli M, Todino V, Graziano F, Panunzi C, Pace D, Guglielmi R . Low-activity (2.0 GBq; 54 mCi) radioiodine post-surgical remnant ablation in thyroid cancer: comparison between hormone withdrawal and use of rhTSH in low-risk patients. Eur J Endocrinol. 2008; 160(3):431-6. DOI: 10.1530/EJE-08-0669. View

14.

Chung J, Youn H, Kang J, Lee H, Kang K . Sodium iodide symporter and the radioiodine treatment of thyroid carcinoma. Nucl Med Mol Imaging. 2014; 44(1):4-14. PMC: 4042960. DOI: 10.1007/s13139-009-0016-1. View

15.

Mazzaferri E . Thyroid remnant 131I ablation for papillary and follicular thyroid carcinoma. Thyroid. 1997; 7(2):265-71. DOI: 10.1089/thy.1997.7.265. View

16.

Haugen B, Pacini F, Reiners C, Schlumberger M, Ladenson P, Sherman S . A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer. J Clin Endocrinol Metab. 1999; 84(11):3877-85. DOI: 10.1210/jcem.84.11.6094. View

17.

Kogai T, Endo T, Saito T, Miyazaki A, Kawaguchi A, Onaya T . Regulation by thyroid-stimulating hormone of sodium/iodide symporter gene expression and protein levels in FRTL-5 cells. Endocrinology. 1997; 138(6):2227-32. DOI: 10.1210/endo.138.6.5189. View

18.

Sawin C, Becker D . Radioiodine and the treatment of hyperthyroidism: the early history. Thyroid. 1997; 7(2):163-76. DOI: 10.1089/thy.1997.7.163. View

19.

Yoo I, Kim S, Seo Y, Oh J, O J, Chung S . The success rate of initial (131)i ablation in differentiated thyroid cancer: comparison between less strict and very strict low iodine diets. Nucl Med Mol Imaging. 2014; 46(1):34-40. PMC: 4042982. DOI: 10.1007/s13139-011-0111-y. View

20.

Cooper D, Doherty G, Haugen B, Hauger B, Kloos R, Lee S . Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009; 19(11):1167-214. DOI: 10.1089/thy.2009.0110. View