Quality of life changes and clinical outcomes in thyroid cancer patients undergoing radioiodine remnant ablation (RRA) with recombinant human TSH (rhTSH): a randomized controlled study

Taïeb, David; Sébag, F.; Черенько, М. С.; Baumstarck, Karine; Fortanier, Cécile; Farman-Ara, Bardia; Micco, C. De; Vaillant, J.-C.; Thomas, Steven J.; Conte-Devolx, B.; Loundou, Anderson; Auquier, Pascal; Henry, Jean François; Mundler, O.

doi:10.1111/j.1365-2265.2008.03424.x

Cited by 92 publications

(89 citation statements)

References 27 publications

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“…QoL has been extensively evaluated in DTC subjects independently of the cognitive and jobrelated disturbances brought about by changes in circulating thyroid hormone levels for diagnostic and therapeutic purposes (Dow et al, 1997;BotellaCarretero et al, 2003;Golger et al, 2003). More recently, the clinical benefits of the use of recombinant human thyroid-stimulating hormone (TSH), versus thyroid hormone withdrawal, on the preservation of QoL have been demonstrated (Schroeder et al, 2006;Taïeb et al, 2009;Lee et al, 2010). On the other hand, few studies have evaluated QoL in DTC subjects on stabilized levo-thyroxine (L-T4) suppressive treatment a long time after primary therapies.…”

Section: Introductionmentioning

confidence: 99%

Five-year longitudinal evaluation of quality of life in a cohort of patients with differentiated thyroid carcinoma

Giusti

Melle

Fenocchio

et al. 2011

J. Zhejiang Univ. Sci. B

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Differentiated thyroid carcinoma (DTC) generally has a favorable outcome. Thyroid disease, treatments, stress, and comorbidity can compromise health-related quality of life (QoL) and indirectly weigh upon the outcome. From 2004 to 2008, we evaluated QoL longitudinally in 128 DTC subjects. During scheduled examinations, subjects were asked to undergo a semi-structured psychiatric interview and five rated inventories. The same examination was conducted in 219 subjects after surgery for benign thyroid pathology. Low scores represent a better QoL. DTC and control subjects were similar in terms of age, male/female ratio, concomitant psychopharmacological treatments, and frequency of psychiatric diseases. In DTC subjects, Billewicz scale (BS) scores showed an increasing trend over time, especially among females. The ad hoc thyroid questionnaire (TQ) scores were similar in both groups and did not change over time, but at the end of the study ad hoc TQ and BS were significantly related. Ad hoc TQ scores were also related to age on entry to the study. In both male and female DTC subjects, Hamilton's tests for anxiety (HAM-A), but not for depression (HAM-D), showed an improving trend. At the end of the study, HAM-A and HAM-D scores were comparable to those of the control group. HAM-A and HAM-D were both positively correlated with the stage of cancer and the time between diagnosis and treatment. Only HAM-D correlated with age on entry to the study. Kellner symptom questionnaire (KSQ) item scores were higher in DTC subjects than in controls. The change over time in the items including anxiety, somatization, depression, and hostility was significant. Somatization and hostility were more significantly reduced in DTC females than in DTC males. Hostility scores were significantly lower in DTC subjects than in controls at the end of the study. Somatization and depression were significantly related to staging on diagnosis and age on entry to the study. Our study confirms a wide variation of illness perception in DTC subjects, which is generally unrelated to the favorable clinical follow-up of the disease. Psychological evaluation during long-term follow-up improved QoL scores, which reached the same levels noted in subjects with a history of thyroid surgery for benign thyroid pathology. Our data indicate that special attention should be paid to QoL in older DTC subjects and those with more severe staging on diagnosis.

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Section: Introductionmentioning

confidence: 99%

Five-year longitudinal evaluation of quality of life in a cohort of patients with differentiated thyroid carcinoma

Giusti

Melle

Fenocchio

et al. 2011

J. Zhejiang Univ. Sci. B

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“…The patient is placed back on levothyroxine suppressive therapy, as appropriate, and approximately 1 week after the treatment dose of RAI, a post-therapy WBS is performed to better assess for residual or metastatic disease. Substitution of rhTSH stimulation for TSH stimulation by THW for diagnostic evaluations (shown in Figure 2b and reviewed by Cooper et al (2006) or for thyroid remnant ablation (shown in Figures 1c and 1d), has been published by a number of centers, allowing patients to remain on levothyroxine therapy and avoid the symptoms of hypothyroidism (Robbins et al 2001;Robbins et al 2002b;Barbaro et al 2003;Barbaro et al 2006;Pacini et al 2006a;Pilli et al 2007;Rosario et al 2008;Taieb et al 2008;Tuttle et al 2008). Over the last 3 years, thyrotropin alfa (Thyrogen ® ) has been approved for RAI ablation by the United States Food and Drug Administration (FDA, 2007), in Europe (2005), and in certain Asian (2007) and South American countries (2006).…”

Section: Management Issues In Thyroid Cancer and Use Of Radioiodinementioning

confidence: 99%

“…One of the randomized trials (Taieb et al 2008) compared subjects who all received 3.7 GBq (100 mCi) 131 I after rhTSH preparation or THW. Subjects received levothyroxine therapy for 1 week and then were randomized to either rhTSH (n = 36) or THW (n = 35) preparation for RAI ablation.…”

Section: Rhtsh For Thyroid Remnant Ablationmentioning

confidence: 99%

Recombinant human thyroid stimulating hormone in 2008: focus on thyroid cancer management

Gramza

Schuff

2009

OTT

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Radioiodine (RAI) ablation following thyroidectomy is standard of care treatment for patients with intermediate or high risk differentiated thyroid cancer. Traditionally, this has been achieved by forgoing thyroid hormone replacement postoperatively, allowing endogenous thyroid stimulating hormone (TSH) levels to rise. This rise in TSH provides the stimulus for RAI uptake by the thyroid remnant, but is associated with clinical hypothyroidism and its associated morbidities. Recombinant human TSH (rhTSH, thyrotropin alfa [Thyrogen ® ], Genzyme Corporation, Cambridge, MA, USA) was developed to provide TSH stimulation without withdrawal of thyroid hormone and clinical hypothyroidism. Phase III studies reported equivalent detection of recurrent or residual disease when rhTSH was used compared with thyroid hormone withdrawal (THW). These trials led to its approval as an adjunctive diagnostic tool for serum thyroglobulin (Tg) testing with or without RAI imaging in the surveillance of patients with differentiated thyroid cancer. Recently, rhTSH was given an indication for adjunctive preparation for thyroid remnant ablation after phase III studies demonstrated comparable outcomes for rhTSH preparation when compared with THW. Importantly, rhTSH stimulation has been found to be safe, well tolerated, and to result in improved quality of life. Here, we review the effi cacy and tolerability studies leading to the approval for the use of rhTSH in well-differentiated thyroid cancer management.

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“…Symptoms described to occur a few weeks after discontinuation of thyroid hormone therapy are changes in peripheral conduction velocity and in the EEG (15). Furthermore, subjective impairments of the quality of life (38)(39)(40) as well as changes in mood (41,42) and decreases in working memory (43) have been reported.…”

Section: Clinical Symptoms During Transient Severe Hypothyroidism Quamentioning

confidence: 99%

Thyroid Hormone Effects on Sensory Perception, Mental Speed, Neuronal Excitability and Ion Channel Regulation

Dietzel¹,

Mohanasundaram²,

Niederkinkhaus³

et al. 2012

Thyroid Hormone

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Quality of life changes and clinical outcomes in thyroid cancer patients undergoing radioiodine remnant ablation (RRA) with recombinant human TSH (rhTSH): a randomized controlled study

Abstract: rhTSH preserves QoL of patients undergoing RRA with similar rates of ablation success compared to hypothyrodism. However, there is a wide heterogeneity in the clinical impact of hypothyroidism.

Cited by 92 publications

References 27 publications

Five-year longitudinal evaluation of quality of life in a cohort of patients with differentiated thyroid carcinoma

Five-year longitudinal evaluation of quality of life in a cohort of patients with differentiated thyroid carcinoma

Recombinant human thyroid stimulating hormone in 2008: focus on thyroid cancer management

Thyroid Hormone Effects on Sensory Perception, Mental Speed, Neuronal Excitability and Ion Channel Regulation

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