Treatment of Metastatic Thyroid Cancer with Radioiodine Following Preparation by Recombinant Human Thyrotropin

Robbins, Richard J.; Folb, Leah; Tuttle, R. Michael

doi:10.1007/978-1-4939-3314-3_57

Cited by 1 publication

(1 citation statement)

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“…Patients were selected for their inability to produce endogenous thyrotropin, for example, in patients with hypopituitarism, those with large tumor burden producing sufficient thyroid hormone to suppress thyrotropin, or because of a medical contraindication to hypothyroidism after THW, such as in patients with unstable angina. Despite the limitations of drawing definitive conclusions from case reports, the studies indicated that rhTSH reliably elevated thyrotropin to levels considerably higher than 30 mUI/L, that most metastatic lesions demonstrated RAI uptake on posttherapy scans, and that patients benefited from the avoidance of symptoms of hypothyroidism [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Differentiated Thyroid Cancer Survival Is Unaffected by Mode of Preparation for 131I Administration

Gomes-Lima

Chittimoju

Wehbeh

et al. 2022

Journal of the Endocrine Society

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Background and Objective Recombinant human thyrotropin (rhTSH) is currently not FDA-approved for the treatment of high-risk patients with differentiated thyroid cancer (DTC). The goal of our study was to compare the outcomes in higher risk patients with metastatic DTC prepared for radioiodine (RAI) therapy with rhTSH versus thyroid hormone withdrawal (THW). Methods Retrospective chart review of patients with metastatic DTC in follow-up at MedStar Washington Hospital Center and MedStar Georgetown University Hospital from 2009 to 2017. Patients were divided according to their preparation for RAI therapy, with assessment of progression free survival (PFS) and overall survival (OS). Results Fifty-five patients with distant metastases (16 men, 39 women) were prepared for RAI therapy exclusively either with rhTSH (n= 27) or with THW (n= 28). There were no statistically significant differences between the groups regarding clinicopathological features and history of RAI therapies. The median follow-up time for patients with rhTSH-aided therapies was 4.2 yr (range 3.3 – 5.5 yr) and for patients with THW-aided therapies was 6.8 yr (range 4.2- 11.6 yr) (p=0.002). Multivariate analysis showed that the method of TSH stimulation was not associated with a difference in PFS or OS. Conclusion As has been shown previously for low-risk DTC, this study indicates that the mode of preparation for RAI therapy does not appear to influence the outcomes of patients with metastatic DTC. PFS and OS were similar for patients with THW-aided or rhTSH-aided RAI therapies.

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Section: Discussionmentioning

confidence: 99%