[Recombinant human thyrotropin in the follow-up of patients with differentiated thyroid carcinoma].
OBJECTIVE
To determine the value of the use of radio-iodine scanning diagnostic and radio-iodine therapy during the follow-up of advanced differentiated thyroid cancer without stopping thyroid hormone suppression therapy.


METHODS
We performed 7 radio-iodine scans and 4 radioiodine therapies in 5 men and 1 woman, aged 39 to 79 years. Five patients had papillary thyroid cancer and one follicular thyroid cancer. Human recombinant thyrotropin was given intramuscularly at a dose of 0.9 mg/ml once a day for two days. Twenty-four hours after the second dose, serum thyrotropin, thyroglobulin (Tg) and thyroglobulin autoantibodies were measured and each patient was given 2 mCi of 131I in postsurgery scans and 5 mCi of 131I in patients previously treated with 131I. Whole-body scans were obtained within 54 hours of injection and in the cases of diagnostic uncertainty a second scan was performed 72 hours after the injection.


RESULTS
Four scans were positive and two were negative. One positive scan patient was not treated due to a serious clinical condition. An effective increase of serum TSH was observed in all 6 patients. Four patients had an effective increase of serum Tg; the other 2 cases had a decrease of serum Tg: One case was undifferentiated and in the other case the mass was smaller after surgery.


CONCLUSIONS
rhTSH is an effective means of stimulating TSH levels and allowing scan and/or radioiodine treatment. rhTSH has no significant adverse effects. The use of rhTSH avoids all the disadvantages of hypothyroidism and maintains quality of life.
Gómez Camarero
P
P
Unidad de Diagnóstico de Medicina Nuclear, Hospitales Universitarios Virgen del Rocío, Sevilla, España.
Martínez Brocca
M A
MA
Rodríguez Rodríguez
J R
JR
Navarro González
E
E
Tirado Hospital
J L
JL
González Duarte
D
D
Vázquez Albertino
R
R
Astorga Jimenez
R
R
D018263:Adenocarcinoma, Follicular / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000556:secondary; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D002454:Cell Differentiation; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000494:pharmacology; D013954:Thyroglobulin / Q000097:blood / Q000276:immunology; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy; D013972:Thyrotropin / Q000097:blood / Q000494:pharmacology
D001323:Autoantibodies; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins; C006606:anti-thyroglobulin; D013972:Thyrotropin; D013954:Thyroglobulin