[The importance of recombinant human thyroid stimulating hormone in the follow-up and treatment of disseminated thyroid cancer after thyroidectomy].
In patients operated for differentiated thyroid cancer (DTC), before thyroid remnant ablation and treatment of metastatic disease, thyroid hormones are withdrawn four to six weeks in order to induce an increase in serum thyroid stimulating hormone (TSH) of more than 25-30 microU/mL and thus to stimulate thyroid gland uptake and retention of iodine-131 ((131)I), given therapeutically. Secretion of thyroglobulin (Taug) is also increased. However, thyroid hormone withdrawal frequently causes clinical hypothyroidism. Recombinant human TSH (rhTSH) can provide TSH stimulation without withdrawal of thyroid hormones. The primary clinical utility of rhTSH has been for the post-surgical monitoring in patients with DTC but is currently an aid in thyroid remnant ablation and treatment of thyroid tumors with encouraging results. In this review we have briefly described the findings reported during the period 1994-2006 concerning the diagnostic and therapeutic usefulness of rhTSH in patients with DTC after total or near total thyroidectomy.
Skoura
Evangelia
E
Nuclear Medicine Department, General Hospital Evangelismos, Ipsilantou 45-47, 10 676 Athens, Greece.
Rontogianni
Phivi
P
D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011182:Postoperative Care / Q000379:methods*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends; D011994:Recombinant Proteins / Q000008:administration & dosage; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D013965:Thyroidectomy; D013972:Thyrotropin / Q000008:administration & dosage* / Q000235:genetics; D016896:Treatment Outcome
D011994:Recombinant Proteins; D013972:Thyrotropin