[Recombinant human thyrotropin in the follow-up of patients with differentiated thyroid carcinoma]

Rev Esp Med Nucl. Sep-Oct 2003;22(5):295-305. doi: 10.1016/s0212-6982(03)72206-x.
[Article in Spanish]

Abstract

Purpose: To determine the value of the use of radio-iodine scanning diagnostic and radio-iodine therapy during the follow-up of advanced differentiated thyroid cancer without stopping thyroid hormone suppression therapy.

Material and methods: We performed 7 radio-iodine scans and 4 radioiodine therapies in 5 men and 1 woman, aged 39 to 79 years. Five patients had papillary thyroid cancer and one follicular thyroid cancer. Human recombinant thyrotropin was given intramuscularly at a dose of 0.9 mg/ml once a day for two days. Twenty-four hours after the second dose, serum thyrotropin, thyroglobulin (Tg) and thyroglobulin autoantibodies were measured and each patient was given 2 mCi of 131I in postsurgery scans and 5 mCi of 131I in patients previously treated with 131I. Whole-body scans were obtained within 54 hours of injection and in the cases of diagnostic uncertainty a second scan was performed 72 hours after the injection.

Results: Four scans were positive and two were negative. One positive scan patient was not treated due to a serious clinical condition. An effective increase of serum TSH was observed in all 6 patients. Four patients had an effective increase of serum Tg; the other 2 cases had a decrease of serum Tg: One case was undifferentiated and in the other case the mass was smaller after surgery.

Conclusions: rhTSH is an effective means of stimulating TSH levels and allowing scan and/or radioiodine treatment. rhTSH has no significant adverse effects. The use of rhTSH avoids all the disadvantages of hypothyroidism and maintains quality of life.

Publication types

  • Case Reports
  • Evaluation Study

MeSH terms

  • Adenocarcinoma, Follicular / diagnostic imaging
  • Adenocarcinoma, Follicular / radiotherapy
  • Adenocarcinoma, Follicular / secondary
  • Adult
  • Aged
  • Autoantibodies / blood
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / secondary*
  • Carcinoma, Papillary / diagnostic imaging*
  • Carcinoma, Papillary / radiotherapy
  • Carcinoma, Papillary / secondary*
  • Carcinoma, Papillary / surgery
  • Cell Differentiation
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Male
  • Middle Aged
  • Radionuclide Imaging
  • Radiopharmaceuticals / therapeutic use
  • Recombinant Proteins / pharmacology
  • Thyroglobulin / blood
  • Thyroglobulin / immunology
  • Thyroid Neoplasms / diagnostic imaging*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / radiotherapy
  • Thyroid Neoplasms / surgery
  • Thyroidectomy
  • Thyrotropin* / blood
  • Thyrotropin* / pharmacology

Substances

  • Autoantibodies
  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • Recombinant Proteins
  • anti-thyroglobulin
  • Thyrotropin
  • Thyroglobulin