Health-related quality-of-life study in patients with carcinoma of the thyroid after thyroxine withdrawal for whole body scanning.
OBJECTIVE
The authors studied the change of health-related quality of life (HR-QOL) in patients with differentiated thyroid carcinoma (DTC) with thyroxine (T4) withdrawal in preparation for whole body radioactive iodine scanning.


METHODS
Seventy-eight patients with DTC and history of radioactive iodine (RAI) ablation were prospectively recruited. They completed the Functional Assessment of Cancer Treatment-General (FACT-G) questionnaire on weeks 0, 2, and 4 after T4 withdrawal with corresponding checking of serum thyroid-stimulating hormone (TSH).


RESULTS
Overall, 74.5% (58 of 78) of patients completed all FACT-G. Comparing FACT-G scores at weeks 0 and 4, "physical" (P < .001), "social" (P = .04), and "emotional" (P = .047) aspects were lowered as well as "total" HR-QOL (P = .001). However, the "functional" domain of HR-QOL was not affected (P = .14). Comparing FACT-G scores at week 0 and 2, we found that "physical" (P = .049) and "total" (P = .05) HR-QOL were affected early (in the first 2 weeks) in T4 withdrawal. Comparison of week 2 and 4 showed that in the later half of the withdrawal period, "physical" (P = .001), "emotional" (P = .02), and "total" FACT-G scores (P = .002) were affected. Mean TSH level (in mIU/L) increased gradually: 2.8 (week 0), 42.8 (week 2), 97 (week 3), and 153 (week 4). The percentage of patients attaining TSH level of >30 mIU/L were 55% (week 2), 96.2% (week 3), and 100% (week 4).


CONCLUSIONS
HR-QOL declines with time of T4 withdrawal. The impact is more severe in the later period of T4 withdrawal. In 3 weeks, 96.2% of our patients attained TSH level of 30 mIU/L. To minimize the impact on HR-QOL, duration of T4 withdrawal can be decreased to 3 weeks.
Chow
Sin-Ming
SM
Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, People's Republic of China. chowsinming@yahoo.com
Au
Kwok-Hung
KH
Choy
Tim-Shing
TS
Lee
Siu-Hong
SH
Yeung
Nga-Yan
NY
Leung
Angus
A
Leung
Alex
A
Leung
Hoi-Leung
HL
Shek
Chi-Chung
CC
Law
Stephen C K
SC
D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D002291:Carcinoma, Papillary / Q000134:cerebrospinal fluid* / Q000208:ethnology / Q000532:radiotherapy*; D004644:Emotions; D005260:Female; D006723:Hong Kong; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000208:ethnology / Q000517:prevention & control*; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013964:Thyroid Neoplasms / Q000097:blood* / Q000208:ethnology / Q000532:radiotherapy*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage* / Q000097:blood
D007457:Iodine Radioisotopes; D013972:Thyrotropin; D013974:Thyroxine