Subject(s)
Carcinoma, Papillary/diagnosis , Carcinoma, Papillary/surgery , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/surgery , Thyroidectomy/methods , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Treatment Outcome , Young AdultABSTRACT
To evaluate tumor recurrence after total thyroidectomy in patients with single papillary carcinoma with size
Subject(s)
Carcinoma, Papillary/radiotherapy , Carcinoma, Papillary/surgery , Thyroid Neoplasms/radiotherapy , Thyroid Neoplasms/surgery , Adult , Biopsy , Carcinoma, Papillary/pathology , Combined Modality Therapy , Female , Humans , Iodine Radioisotopes/therapeutic use , Male , Middle Aged , Neoplasm Recurrence, Local/prevention & control , Radiotherapy, Adjuvant , Thyroid Gland/pathology , Thyroid Neoplasms/pathology , Thyroidectomy , Treatment Outcome , Whole Body ImagingABSTRACT
Thyroxine (T4) withdrawal or recombinant TSH is used for the stimulation of thyroglobulin (Tg), whole-body scanning (WBS) and iodine-131 treatment in patients with thyroid carcinoma. This study evaluated the T4 dose reduction protocol as an alternative for patients' preparation. Fifty-one patients were submitted to total T4 withdrawal for WBS and Tg measurement. T4 treatment was then resumed and maintained until TSH reached levels < 0.3 mIU/l. The T4 dose was then decreased to 0.8 microg/kg/day and TSH was measured weekly. Tg was assayed when TSH was > 30 mIU/l. Patients diagnosed with the disease upon initial evaluation were treated. We also evaluated the clinical and laboratory changes observed for both preparations. Using the reduced dose protocol, TSH levels > 30 mIU/l were reached within 6 and 8 weeks in 84.6 and 100% of the patients, respectively. T4 withdrawal was associated with more common symptoms of hypothyroidism and elevation of creatine kinase (CK) and LDL cholesterol. The T4 dose reduction protocol proved to be useful for Tg stimulation and ablative therapy, without the complication of severe hypothyroidism or the cost of recombinant TSH.
Subject(s)
Carcinoma/radiotherapy , Iodine Radioisotopes/therapeutic use , Thyroglobulin/blood , Thyroid Neoplasms/radiotherapy , Thyroxine/administration & dosage , Adult , Carcinoma/blood , Carcinoma/surgery , Case-Control Studies , Cholesterol, LDL/blood , Creatine Kinase/analysis , Creatine Kinase/blood , Female , Humans , Immunoradiometric Assay , Male , Middle Aged , Thyroglobulin/biosynthesis , Thyroid Neoplasms/blood , Thyroid Neoplasms/surgery , Thyroidectomy , Thyrotropin/blood , Thyroxine/adverse effects , Treatment Outcome , Whole Body ImagingABSTRACT
A suspensão da tiroxina (T4) ou o TSH recombinante são usados para a estimulação da tireoglobulina (Tg), para o mapeamento de corpo inteiro (MCI) e para o tratamento com 131Iodo em pacientes com carcinoma tireoideano. Esse estudo avaliou um protocolo de redução de dose do T4 como alternativa para o preparo desses pacientes. Cinquenta e um pacientes submeteram-se à suspensão total de T4 para o MCI e a medida de Tg. Tratamento com T4 foi então reinstituído e mantido até que o TSH atingisse níveis < 0.3 mUI/l. A dose de T4 foi então dominuída para 0,8 µg/kg/dia e o TSH medido semanalmente. A Tg foi analisada quando o TSH estava > 30 mUI/l. Pacientes diagnosticados com a doença na fase inicial da avaliação foram tratados. Nós também avaliamos as alterações clínicas e laboratoriais observadas para ambos os preparos. Usando o protocolo de redução de dose, níveis de TSH > 30 mUI/l foram atingidos em 6 e 8 semanas em 84,6 and 100% dos pacientes, respectivamente. A suspensão do T4 esteve associada com sintomas mais comuns de hipotireoidismo e com elevação da creatino- quinase (CK) e LDL-colesterol. O protocolo de redução da dose de T4 mostrou-se útil para a estimulação da Tg e terapia ablativa, sem apresentar as complicações do hipotireoidismo severo ou chegar ao custo do TSH recombinante.
