Sick leave for follow-up control in thyroid cancer patients: comparison between stimulation with Thyrogen and thyroid hormone withdrawal

Borget, Isabelle; Corone, C.; Nocaudie, M.; Allyn, Mark; Iacobelli, Sylviane; Schlumberger, Martin; Pouvourville, Gérard de

doi:10.1530/eje-06-0724

Cited by 71 publications

(74 citation statements)

References 22 publications

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“…Referred to in some studies, the greater impact on the quality of life in patients with thyroid nodules, during induction for the state of hypothyroidism, is the influence of psychological and physical well-being issues, with low vitality and decreased capacity of their daily activities 29 .…”

Section: Discussionmentioning

confidence: 99%

Qualidade de vida relacionada à voz e à deglutição, a curto prazo, em pacientes submetidos à radioiodoterapia por carcinoma diferenciado de tireoide

Nascimento¹,

Angelis

Lima

2015

Rev. CEFAC

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Qualidade de vida relacionada à voz e à deglutição, a curto prazo, em pacientes submetidos à radioiodoterapia por carcinoma diferenciado de tireoide José Ribamar do Nascimento Junior (1) , Elisabete Carrara-de Angelis (2) , Eduardo Nóbrega Pereira Lima (3)Instituto de Gerenciamento em deglutição -IGD São Paulo, SP, Brasil.Departamento de Fonoaudiologia do Hospital AC Camargo São Paulo, SP, Brasil.Departamento de Medicina Nuclear do Hospital AC Camargo, São Paulo, SP, Brasil. Conflict of interest: non-existentThe main structures at risk during thyroid surgery are the recurrent laryngeal nerves and parathyroid glands. The removal of the parathyroid glands can lead to hypoparathyroidism and consequent hypocalcemia 1,3 . Lesion to the inferior recurrent laryngeal nerve can result in vocal fold paralysis, which may cause permanent hoarseness. If the lesion is bilateral, aphonia and dyspnea are results of changes in the vocal folds 4 .In thyroid surgery, its comorbidities is postsurgical therapy with ¹³¹I leading to prolonged survival, and patients may present vocal alterations, dysphagia, sialadenitis, taste changes and xerostomia 5 .Sialadenitis is a possible side effect seen in treatment with high doses of ¹³¹I and correlates with the amount administered and physiological uptake, usually bilateral, in the region of the parotid or submandibular glands, which occurs within 48 INTRODUTCIONDiseases of the thyroid gland are common, affecting approximately 11% of the general population, with a predominance of female involvement over male in a ratio of 4:1 1 . The initial treatment of well-differentiated thyroid carcinoma consists in most cases of total or near total thyroidectomy with subsequent remnant ablation with iodine radioisotope (¹³¹I) followed by L-thyroxine (L-T4) suppression 2 . ABSTRACTPurpose: to analyze the quality of life related to voice and swallowing before and after radioiodine therapy in the short term. Methods: thiroidectomized individuals indicated RAI underwent two questionnaires on quality of life related to voice and swallowing before and three months after radioiodine therapy. Results: 32 patients, 84 % female and 16% male, were studied with a mean age of 46 years. The histological type was the classic papillary carcinoma (56%). The results indicated a tendency for better quality of life with respect to voice three months after radioiodine therapy. The protocol for quality of life related to swallowing also indicated better quality of life in the second assessment. A larger with minimal limitation on the quality of life questionnaire in swallowing was observed. Conclusion: quality of life and voice and swallowing symptoms in the short term after radioiodine therapy is better compared to pretreatment. It is necessary to investigate other aspects such as metabolic, surgical and individual to define the real impact of radioiodine therapy on quality of life.

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Section: Discussionmentioning

confidence: 99%

Qualidade de vida relacionada à voz e à deglutição, a curto prazo, em pacientes submetidos à radioiodoterapia por carcinoma diferenciado de tireoide

Nascimento¹,

Angelis

Lima

2015

Rev. CEFAC

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“…One of the major drawbacks for its more generalized use is its cost (16). Although it is believed that it can be counterbalanced by improved productivity and reduced work absenteeism when hypothyroidism is avoided (17,18), its exact economic impact is difficult to ascertain (19). Our primary goal was to evaluate the whole-body retention time of 131 I, extrapolated from the measurements of the effective dose at a 1-m distance, associated with each strategy of preparing patients for postoperative remnant ablation with 131 I.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of whole-body retention of iodine-131 (131I) after postoperative remnant ablation for differentiated thyroid carcinoma – thyroxine withdrawal versus rhTSH administration: A retrospective comparison

2011

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Abstract. Previous studies demonstrated that preparation with recombinant human thyroid-stimulating hormone (rhTSH) for thyroid remnant ablation results in lower extrathyroidal radiation compared to hypothyroidism. The results of 50 radioiodine therapies (RITs) under rhTSH, regarding iodine half-life, were evaluated and compared with 50 RITs performed on patients with hypothyroidism following thyroxine withdrawal. The patients were treated with 3700 MBq (100 mCi) of 131 I. Forty-eight hours after RIT, patients were measured with a radiation detector at a 1-meter (m) distance for evaluation of the effective dose (µSv/h). TSH and thyroglobulin (Tg) maximal values were also compared. rhTSH-stimulated patients had a significantly lower whole-body retention of 131 I (8.5±7.3 µSv/h), extrapolated from the measurements of the effective dose at a 1-m distance, compared to endogenously stimulated patients (13.6±8.1 µSv/h; p=0.001). Furthermore, TSH mean and Tg median levels were significantly higher in the rhTSH-stimulated patients (89.9±15.3 mU/l and 7.7 ng/ml, respectively) compared to the hypothyroid group (59.2±25.1 mU/l and 3.3 ng/ml; p<0.001 and p=0.003, respectively). Compared to thyroid hormone withdrawal, the use of rhTSH prior to RIT was associated with significantly lower whole-body retention of 131 I and with greater efficacy in reaching TSH levels greater than 30 mU/l, confirming data previously described.

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“…Those who were treated with rhTSH, when compared to those treated by THW, were less likely to require sick leave (11% vs 33%, p = 0.001). Among those who did require sick leave, the mean duration was shorter (3.1 vs 11.2 days, p = 0.002) (Borget et al 2007).…”

Section: Quality Of Lifementioning

confidence: 93%

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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Sick leave for follow-up control in thyroid cancer patients: comparison between stimulation with Thyrogen and thyroid hormone withdrawal

Cited by 71 publications

References 22 publications

Qualidade de vida relacionada à voz e à deglutição, a curto prazo, em pacientes submetidos à radioiodoterapia por carcinoma diferenciado de tireoide

Qualidade de vida relacionada à voz e à deglutição, a curto prazo, em pacientes submetidos à radioiodoterapia por carcinoma diferenciado de tireoide

Evaluation of whole-body retention of iodine-131 (131I) after postoperative remnant ablation for differentiated thyroid carcinoma – thyroxine withdrawal versus rhTSH administration: A retrospective comparison

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

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