title: The effectiveness of recombinant human thyroid-stimulating hormone versus thyroid hormone withdrawal prior to radioiodine remnant ablation in thyroid cancer: a meta-analysis of randomized controlled trials.
abstract: We evaluated the efficacy of recombinant human thyroid-stimulating hormone (rhTSH) versus thyroid hormone withdrawal (THW) prior to radioiodine remnant ablation (RRA) in thyroid cancer. A systematic search of MEDLINE, EMBASE, the Cochrane Library, and SCOPUS was performed. Randomized controlled trials that compared ablation success between rhTSH and THW at 6 to 12 months following RRA were included in this study. Six trials with a total of 1,660 patients were included. When ablation success was defined as a thyroglobulin (Tg) cutoff of 1 ng/mL (risk ratio, 0.99; 95% confidence interval, 0.96-1.03) or a Tg cutoff of 1 ng/mL plus imaging modality (RR 0.97; 0.90-1.05), the results of rhTSH and THW were similar. There were no significant differences when ablation success was defined as a Tg cutoff of 2 ng/mL (RR 1.03; 0.95-1.11) or a Tg cutoff of 2 ng/mL plus imaging modality (RR 1.02; 0.95-1.09). When a negative (131)I-whole body scan was used solely as the definition of ablation success, the effects of rhTSH and THW were not significantly different (RR 0.97; 0.93-1.02). Therefore, ablation success rates are comparable when RRA is prepared by either rhTSH or THW.
authors.affiliation: Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea. ; Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea. ; Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Kyoungjune
authors.identifier: 0000-0001-5051-1894
authors.initials: K
authors.lastname: Pak
authors.affiliation: Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea. ; Cancer Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: Gi Jeong
authors.identifier: 0000-0002-1360-5186
authors.initials: GJ
authors.lastname: Cheon
authors.affiliation: Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea. ; Cancer Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: Keon Wook
authors.identifier: 0000-0003-2622-9017
authors.initials: KW
authors.lastname: Kang
authors.affiliation: Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea. ; Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Seong-Jang
authors.identifier: 0000-0001-5803-9934
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea. ; Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: In-Joo
authors.identifier: 0000-0003-1307-6146
authors.initials: IJ
authors.lastname: Kim
authors.affiliation: WCU Graduate School of Concergence Science and Technology, Seoul National University College of Medicine, Seoul, Korea. ; University of California at Irvine, CA, USA.
authors.forename: E Edmund
authors.identifier: 0000-0002-3915-2525
authors.initials: EE
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea. ; Cancer Research Institute, Seoul National University Hospital, Seoul, Korea. ; WCU Graduate School of Concergence Science and Technology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong Soo
authors.identifier: 0000-0001-9013-4835
authors.initials: DS
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea. ; Cancer Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: June-Key
authors.identifier: 0000-0002-6866-8571
authors.initials: JK
authors.lastname: Chung
mesh_terms: D017115:Catheter Ablation; D002986:Clinical Trials as Topic; D016208:Databases, Factual; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000096:biosynthesis / Q000235:genetics / Q000627:therapeutic use; D012306:Risk; D013954:Thyroglobulin / Q000032:analysis / Q000378:metabolism; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013972:Thyrotropin / Q000235:genetics / Q000378:metabolism / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography; D051598:Whole Body Imaging
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins; D013972:Thyrotropin; D013954:Thyroglobulin
keywords: Thyroid Neoplasms; Thyrotropin Alfa