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Nucl Med Rev Cent East Eur ; 7(1): 13-9, 2004.
Article in English | MEDLINE | ID: mdl-15318305

ABSTRACT

BACKGROUND: Recombinant human TSH (rhTSH) has been developed to facilitate the follow-up for persistent or recurrent differentiated thyroid cancer (DTC), avoiding the hypothyroid symptoms after the withdrawal of Levothyroxine (L-T4) suppressive therapy. MATERIAL AND METHODS: To analyse the effect of rhTSH in providing stimulation of radioiodine uptake (RAIU) for the ablation of thyroid remnant and/or malignant thyroid tissue in patients with metastatic DTC. Ten subjects (4 women, 6 men), mean age 53 years, with DTC (7 papillary, 2 follicular and 1 Hürthle-cell), requiring radioiodine therapy (RIT) were studied. Nine of them had a positive diagnostic whole body scan (dWBS) or CT for thyroid remnant, lymph nodes and/or distant metastases. One patient with an invasive tall cell PTC had an increased serum Tg and a negative dWBS. Serum TSH was measured before and two days after the rhTSH injection. Thyroglobulin measurements were performed before the rhTSH administration, 3 and 6 months after RIT. There were no serious side effects of the rhTSH application. RESULTS: Serum TSH after the rhTSH injection rose to 156.5 +/- +/- 60.9 mIU/L and induced RAIU in 8 out of 10 patients. Basal serum Tg was increased in 6 patients and decreased three months later in 2 of them. The post-therapy WBS (pthWBS) showed: 1) additional metastatic lesions in 3 patients with positive dWBS, 2) lung nodular metastases in 1 patient with negative dWBS, 3) similar image as the dWBS in 4 patients, 4) negative image in 1 patient with positive dWBS. CONCLUSION: RhTSH is a safe and promising method for the stimulation of RAIU in patients with thyroid remnant and/or persistent or recurrent DTC, avoiding L-T4 withdrawal.


Subject(s)
Neoplasm Recurrence, Local/drug therapy , Neoplasm Recurrence, Local/radiotherapy , Radiation Tolerance/drug effects , Thyroid Neoplasms/drug therapy , Thyroid Neoplasms/radiotherapy , Thyrotropin/administration & dosage , Adult , Aged , Chemotherapy, Adjuvant/methods , Female , Humans , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/surgery , Radiation-Sensitizing Agents/administration & dosage , Recombinant Proteins/administration & dosage , Recombinant Proteins/genetics , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/surgery , Thyrotropin/genetics , Treatment Outcome
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