title: Recombinant human thyrotropin stimulated131I treatment for multinodular goiter.
abstract: The aim of the study was to investigate the effects of rhTSH stimulation before131I treatment in patients with MNG.
  
  
  METHODS
  Sources included the Cochrane Library, MEDLINE, EMBASE, and SCOPUS database (all until January 2016). Randomized controlled trials (RCTs) that assessed the efficacy of rhTSH-stimulated131I treatment compared to placebo or131I treatment alone were collected. Two authors performed the data extraction independently.
  
  
  RESULTS
  Six RCTs involving 294 patients with MNG were included in this review. Altogether 168 patients were randomized to rhTSH-stimulated131I therapy, and 126 to either placebo and131I or131I alone. rhTSH-stimulated131I vs placebo and131I or131I alone for MNG showed no statistically significant difference in quality of life and all-cause mortality. rhTSH- (at a dose of 0.03 mg and above) stimulated131I treatment for MNG showed significant benefits in thyroid volume reduction.131I treatment with rhTSH stimulation at high doses (0.03 mg, 0.1 mg, 0.3 mg and 0.45 mg) for MNG caused significantly higher adverse effects and hypothyroidism.
  
  
  CONCLUSIONS
  The overall results indicated that using rhTSH at high doses of 0.03-0.45 mg before131I therapy resulted in a greater TVR than131I therapy alone for patients with non-toxic MNG. However, an increased incidence of adverse effects and hypothyroidism was observed in patients receiving high-dose of rhTSH pretreatment than in patients who received low-dose rhTSH pretreatment. Therefore, a dose of 0.03 mg rhTSH pretreatment before131I therapy may be more potent than131I alone in treating patients with non-toxic MNG who either had a contraindication for or declined surgery.
authors.forename: Limin
authors.initials: L
authors.lastname: Tang
authors.forename: Tiekun
authors.initials: T
authors.lastname: Ma
authors.affiliation: Dr. Fengyu Wu, Haier Road 59, Qingdao 266003, China, E-Mail: wfyqingdao@sina.com.
authors.forename: Fengyu
authors.initials: F
authors.lastname: Wu
mesh_terms: D059248:Chemoradiotherapy / Q000401:mortality*; D006044:Goiter, Nodular / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage*; D011836:Radiation Tolerance / Q000187:drug effects; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000008:administration & dosage; D015996:Survival Rate; D013972:Thyrotropin / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins; D013972:Thyrotropin
keywords: Goiter; rhTSH