PMID- 18803678
OWN - NLM
STAT- MEDLINE
DCOM- 20091013
LR  - 20220330
IS  - 1365-2265 (Electronic)
IS  - 0300-0664 (Linking)
VI  - 71
IP  - 1
DP  - 2009 Jul
TI  - Quality of life changes and clinical outcomes in thyroid cancer patients 
      undergoing radioiodine remnant ablation (RRA) with recombinant human TSH (rhTSH): 
      a randomized controlled study.
PG  - 115-23
LID - 10.1111/j.1365-2265.2008.03424.x [doi]
AB  - BACKGROUND: Recombinant human TSH (rhTSH) has become the modality of choice for 
      radioiodine remnant ablation (RRA) in low-risk thyroid cancer patients. AIMS AND 
      METHODS: The aims of the present prospective randomized study were to evaluate 
      the impact of TSH stimulation procedure (hypothyroidism vs. rhTSH) on quality of 
      life (QoL) of thyroid cancer patients undergoing RRA and to evaluate efficacy of 
      both procedures. L-T4 was initiated in both groups after thyroidectomy. After 
      randomization, L-T4 was discontinued in hypothyroid (hypo) group and continued in 
      rhTSH group. A measure of 3.7 GBq of radioiodine was given to both groups. The 
      functional assessment of chronic illness therapy-fatigue (FACIT-F) was 
      administered from the early postoperative period to 9 months. Socio-demographic 
      parameters, anxiety and depression scales were also evaluated (CES-D, BDI and 
      Spielberger state-trait questionnaires). At 9 months, patients underwent an rhTSH 
      stimulation test, diagnostic (131)I whole body scan (dxWBS) and neck 
      ultrasonography. RESULTS: A total of 74 patients were enrolled for the study. 
      There was a significant decrease in QoL from baseline (t0) to t1 (RRA period) in 
      the hypothyroid group with significant differences in FACIT-F TOI (P < 10(-3)), 
      FACT-G total score (P = 0.005) and FACIT-F total score (P = 0.003). By contrast, 
      QoL was preserved in the rhTSH group. In the multivariate analysis, FACIT-TOI 
      changes were only affected by the modality of TSH stimulation performed for RRA. 
      From 3 to 9 months, changes of QoL scales and subscales were no longer 
      statistically different in both groups of patients. Based on serum 
      rhTSH-stimulated Tg alone (Tg < 0.8 microg/l, BRAHMS Tg Kryptor), no difference 
      in ablation success was observed between rhTSH and hypothyroidism groups, 91.7% 
      and 97.1%, respectively. A higher rate of persistent thyroid remnants was 
      observed in the rhTSH arm, although in most cases uptake was < 0.1% and of no 
      clinical significance. CONCLUSIONS: rhTSH preserves QoL of patients undergoing 
      RRA with similar rates of ablation success compared to hypothyrodism. However, 
      there is a wide heterogeneity in the clinical impact of hypothyroidism.
FAU - Taieb, D
AU  - Taieb D
AD  - Service Central de Biophysique et de Medecine Nucleaire, Centre 
      Hospitalo-Universitaire de la Timone, Marseille Cedex 5, France. 
      david.taieb@ap-hm.fr
FAU - Sebag, F
AU  - Sebag F
FAU - Cherenko, M
AU  - Cherenko M
FAU - Baumstarck-Barrau, K
AU  - Baumstarck-Barrau K
FAU - Fortanier, C
AU  - Fortanier C
FAU - Farman-Ara, B
AU  - Farman-Ara B
FAU - De Micco, C
AU  - De Micco C
FAU - Vaillant, J
AU  - Vaillant J
FAU - Thomas, S
AU  - Thomas S
FAU - Conte-Devolx, B
AU  - Conte-Devolx B
FAU - Loundou, A
AU  - Loundou A
FAU - Auquier, P
AU  - Auquier P
FAU - Henry, J F
AU  - Henry JF
FAU - Mundler, O
AU  - Mundler O
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20080918
PL  - England
TA  - Clin Endocrinol (Oxf)
JT  - Clinical endocrinology
JID - 0346653
RN  - 0 (Iodine Radioisotopes)
RN  - 0 (Recombinant Proteins)
RN  - 9002-71-5 (Thyrotropin)
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Iodine Radioisotopes/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - *Quality of Life
MH  - Recombinant Proteins/therapeutic use
MH  - Thyroid Neoplasms/*drug therapy
MH  - Thyrotropin/*therapeutic use
MH  - Treatment Outcome
EDAT- 2008/09/23 09:00
MHDA- 2009/10/14 06:00
CRDT- 2008/09/23 09:00
PHST- 2008/09/23 09:00 [pubmed]
PHST- 2009/10/14 06:00 [medline]
PHST- 2008/09/23 09:00 [entrez]
AID - CEN3424 [pii]
AID - 10.1111/j.1365-2265.2008.03424.x [doi]
PST - ppublish
SO  - Clin Endocrinol (Oxf). 2009 Jul;71(1):115-23. doi: 
      10.1111/j.1365-2265.2008.03424.x. Epub 2008 Sep 18.