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Evidence summaries

Recombinant Human Thyrotropin (rhTSH) Aided Radioiodine Treatment for Remnant Ablation in Differentiated Thyroid Cancer

Recombinant human thyrotropin (rhTSH) aided radioiodine appears to be as effective as thyroid hormone withdrawal on iodine-131 thyroid remnant ablation and may decrease whole body radiation exposure. Level of evidence: "C"

A Cochrane review [Abstract] 1assessed four RCTs including 223 patients with differentiated thyroid cancer comparing recombinant human thyrotropin (rhTSH) to thyroid hormone withdrawal (THW) in preparing patients for radio-iodine remnant ablation. There were no statistically significant differences in terms of successful ablation rate using rhTSH (102 patients, two trials, 47/49 vs. 52/53; OR 0.48, 95 % CI 9.04 to 5.68) compared to THW but significant benefits in radiation exposure to blood and bone marrow (109 patients, two trials). One study reported on benefits in some aspects of health-related quality of life. Maximum follow up was 12 months.

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and by imprecise results).

    References

    • Ma C, Xie J, Liu W, Wang G, Zuo S, Wang X, Wu F. Recombinant human thyrotropin (rhTSH) aided radioiodine treatment for residual or metastatic differentiated thyroid cancer. Cochrane Database Syst Rev 2010 Nov 10;11:CD008302. [PubMed]

Primary/Secondary Keywords