title: Recombinant human thyrotropin preparation for adjuvant radioiodine treatment in children and adolescents with differentiated thyroid cancer.
abstract: OBJECTIVE
  Although recombinant human thyrotropin (rhTSH) is widely used in treating differentiated thyroid cancer (DTC), almost all clinical investigation has been in adults. The aim of our retrospective study was to evaluate outcomes of adjuvant, rhTSH-aided radioiodine treatment in children/adolescents with DTC and to compare them to (131)I therapy during l-thyroxin withdrawal (THW).
  
  
  METHODS
  Patients with the diagnosis of DTC who were ≤18 years of age and had no signs of persistent disease at the time of (131)I treatment were included; 48 patients were treated after rhTSH (rhTSH group) and 82 after THW group. The median time of follow-up after therapy was 67 months and was longer in the THW group (99 vs 43 months, P<0.05).
  
  
  RESULTS
  On the day of (131)I administration, all but one patient had TSH levels above 25 μIU/ml. Peak TSH concentration was significantly higher in the rhTSH group (152 μIU/ml vs 91 μIU/ml). Similarly, the thyroglobulin concentration was higher in the rhTSH group (9.7 ng/ml vs 1.8 ng/ml). No side effects requiring medical intervention were recorded after rhTSH administration. The evaluation of disease outcomes during TSH stimulation (6-18 months after (131)I treatment) revealed equal rates of thyroid ablation (71%) in both groups. During subsequent follow-up, five patients showed recurrence (P>0.05).
  
  
  CONCLUSIONS
  In children/adolescents, rhTSH-aided adjuvant radioiodine treatment is associated with rates of remnant ablation and short-term recurrence similar to THW. As this preparation has several advantages over THW, rhTSH may become the preferred method of TSH stimulation once studies of long-term outcomes show non-inferiority to THW in this age group.
authors.affiliation: Department of Nuclear Medicine and Endocrine OncologyMaria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 14, 44-100 Gliwice, Poland dhandkiewicz@io.gliwice.pl.
authors.forename: Daria
authors.initials: D
authors.lastname: Handkiewicz-Junak
authors.affiliation: Department of Nuclear Medicine and Endocrine OncologyMaria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 14, 44-100 Gliwice, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Gawlik
authors.affiliation: Department of Nuclear Medicine and Endocrine OncologyMaria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 14, 44-100 Gliwice, Poland.
authors.forename: Jozef
authors.initials: J
authors.lastname: Rozkosz
authors.affiliation: Department of Nuclear Medicine and Endocrine OncologyMaria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 14, 44-100 Gliwice, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Puch
authors.affiliation: Department of Nuclear Medicine and Endocrine OncologyMaria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 14, 44-100 Gliwice, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Michalik
authors.affiliation: Department of Nuclear Medicine and Endocrine OncologyMaria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 14, 44-100 Gliwice, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Gubala
authors.affiliation: Department of Nuclear Medicine and Endocrine OncologyMaria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 14, 44-100 Gliwice, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Krajewska
authors.affiliation: Department of Nuclear Medicine and Endocrine OncologyMaria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 14, 44-100 Gliwice, Poland.
authors.forename: Aneta
authors.initials: A
authors.lastname: Kluczewska
authors.affiliation: Department of Nuclear Medicine and Endocrine OncologyMaria Sklodowska-Curie Memorial Institute and Centre of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 14, 44-100 Gliwice, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Jarzab
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000532:radiotherapy*; D000293:Adolescent; D002277:Carcinoma / Q000532:radiotherapy*; D002291:Carcinoma, Papillary; D002648:Child; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D018714:Radiotherapy, Adjuvant / Q000379:methods; D011994:Recombinant Proteins; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000532:radiotherapy*; D013965:Thyroidectomy; D013972:Thyrotropin / Q000627:therapeutic use*; D013974:Thyroxine / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes; D011994:Recombinant Proteins; D013972:Thyrotropin; D013974:Thyroxine