title: An easy schedule for postsurgical radioiodine administration in newly diagnosed differentiated thyroid carcinoma patients.
abstract: OBJECTIVE
  To validate the simplest approach to preparing patients with differentiated thyroid carcinoma (DTC) for (131) I-administration ((131) I-A), minimizing the impact of hypothyroidism.
  
  
  METHODS
  Panel study.
  
  
  METHODS
  Ninety patients with DTC were enrolled in the study. Sixty (Group A) underwent total thyroidectomy (TT); L-T4 was not administered in preparation for (131) I-A planned for 3 weeks later. Thirty patients (Group B) with previous TT and (131) I-A stopped L-T4 in preparation for clinical evaluation, including whole-body scanning (WBS)/radioiodine therapy during thyrotrophin (TSH) stimulation planned for 3 weeks (or more) later.
  
  
  METHODS
  Thyrotrophin was measured the day before TT for group A, during L-T4 for group B (baseline-time 1) and then every week until it reached ≥ 30 mIU/l (time 2). Quality of life (QoL) was evaluated by Billewicz index.
  
  
  RESULTS
  At week 3, 100% of patients in group A and 56.6% of group B exceeded TSH > 30 mIU/l. In group B, the cut-off was achieved in four patients at the fourth week (TSH 38.6 ± 8.7 mIU/l), in 3 at the fifth (53.2 ± 3) and in 6 at the sixth (42.3 ± 6.1). From time 1 to time 2, total QoL scores were less affected in group A (percentage decrease: 105%) than in group B (218%). At time 2, the total score was >+19 in group A in 46 patients and in 30 in group B. In group A, TSH levels in the higher tertile of QoL (61 ± 6 mIU/l) were not different from those in the lower tertile (62.3 ± 11.1)(P > 0.1); similar results were seen in group B (69.3 ± 13.3 vs 62.9 ± 13.1)(P > 0.1). There was a positive correlation between the time to obtain TSH ≥ 30 mIU/l and total QoL scores.
  
  
  CONCLUSIONS
  Quality of life scores were not affected by thyrotrophin was measured the day before TT levels as absolute values. A longer time to obtain TSH ≥ 30 mIU/l was positively correlated with worse scores of QoL. We suggest 3 weeks without therapy can be used as an easy schedule in patients who undergo TT for DTC.
authors.affiliation: Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Gelsy A
authors.initials: GA
authors.lastname: Lupoli
authors.forename: Maria R
authors.initials: MR
authors.lastname: Poggiano
authors.forename: Annalisa
authors.initials: A
authors.lastname: Panico
authors.forename: Luciana
authors.initials: L
authors.lastname: Granieri
authors.forename: Roberta
authors.initials: R
authors.lastname: Lupoli
authors.forename: Marianna
authors.initials: M
authors.lastname: Cacciapuoti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lupoli
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes