Surgery and radioablation therapy combined: introducing a 1-week-condensed procedure bonding total thyroidectomy and radioablation therapy with recombinant human TSH

被引：18

作者：

Emmanouilidis, Nikos ^{[1
]}

Mueller, Joerg A. ^{[2
]}

Jaeger, Mark D. ^{[1
]}

Kaaden, Stephan ^{[1
]}

Helfritz, Fabian A. ^{[1
]}

Guener, Zeynep ^{[1
]}

Kespohl, Holger ^{[1
]}

Knitsch, Wolfgang ^{[1
]}

Knapp, Wolfram H. ^{[2
]}

Klempnauer, Juergen ^{[1
]}

Scheumann, Georg F. W. ^{[1
]}

机构：

[1] Hannover Med Sch, Rudolf Pichlmayr Transplantat Forschungszentrum, Klin Viszeral & Transplantat Chirurg, D-30625 Hannover, Germany

[2] Hannover Med Sch, Rudolf Pichlmayr Transplantat Forschungszentrum, Klin Nukl Med, D-30625 Hannover, Germany

来源：

EUROPEAN JOURNAL OF ENDOCRINOLOGY | 2009年 / 161卷 / 05期

关键词：

QUALITY-OF-LIFE; HUMAN THYROTROPIN; HORMONE WITHDRAWAL; RADIOIODINE TREATMENT; FOLLOW-UP; CARCINOMA; CANCER; PAPILLARY; THYROXINE; ABLATION;

D O I：

10.1530/EJE-08-0641

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: The objective of this study was to determine whether the use of recombinant human TSH (rhTSH) to stimulate radioiodine uptake after thyroidectomy is Lis efficacious Lis a period of withholding thyroid hormones, while Lit the same time avoiding hypothyroidism, reducing sick leave time and shortening the hospital stay. Design: Our aim was to compare the standard procedure of differentiated thyroid cancer treatment. which consists of thyroidectomy followed by 4 weeks of hypothyroidism and a conclusive ablative activity of (131)iodine, with a new shortened treatment in which L-thyroxine (T(4)) medication is initiated a day after thyroidectomy. followed by application of rhTSH stimulation and Subsequent ablation a few days after surgery We presumed our treatment to represent the most sophisticated strategy for the reduction in sick leave days overall without any reduction in safety or the efficacy of ablative therapy. Methods: Patients (n=25) were randomized either for surgery and rhTSH stimulation or surgery and L-T(4) abstinence before the first application of radioiodine. Ablation Success was determined by neck ultrasound and serum thyroglobulin during follow-up. RhTSH receivers were monitored for an average of 635 days (S.D.+/- 289) and patients in L-T(4) abstinence for an average of 624 days (S.D.+/- 205). Both groups were statistically compared for significant differences in treatment efficacy safety and overall time of sick leave. Results and conclusions: Our shortened treatment proved to be equally efficacious and safe in comparison with the conventional therapy regimen. At the same time. it showed economic advantages through the reduction in average sick leave time from similar to 29 days (L-T(4) abstinence) down to similar to 6 days (rhTSH stimulation) as well Lis sustaining the patient's quality of life by the complete avoidance of hypothyroidism.

引用

页码：763 / 769

页数：7

共 19 条

[1] Using recombinant human thyroid-stimulating hormone for the diagnosis of recurrent thyroid cancer [J].