Radioiodine Ablation of Thyroid Remnants after Preparation with Recombinant Human Thyrotropin in Differentiated Thyroid Carcinoma: Results of an International, Randomized, Controlled Study

Pacini, Furio; Pw, Ladenson; Schlumberger, Martin; Driedger, Al; Luster, Markus; Rt, Kloos; Sherman, Steven I.; Haugen, Bryan R.; Corone, C.; Molinaro, Eleonora; Elisei, Rossella; Ceccarelli, Claudia; Pinchera, Aldo; Wahl, Richard L.; Leboulleux, Sophie; Ricard, M.; Yoo, John; Busaidy, NL; Delpassand, Ebrahim S.; Hänscheid, Heribert; Felbinger, Ralph; Laßmann, Michael; Reiners, Christoph

doi:10.1210/jc.2005-1651

Cited by 392 publications

(264 citation statements)

References 22 publications

Supporting

Mentioning

236

Contrasting

Unclassified

Order By: Relevance

“…In contrast, the results from this pivotal trial did show a significant and sizeable impairment in quality of life in the hypothyroid group compared with well-preserved quality of life in the rhTSH group (11). In the rhTSHstimulated group, the SF-36 score had increased from baseline in seven of eight domains by the time of ablation.…”

Section: Introductionmentioning

confidence: 62%

“…This may include severe lethargy and fatigue,while enabling patients to remain euthyroid (7)(8)(9)(10). In addition, a multi-centre, randomised, controlled trial has directly compared the use of rhTSH preparation with the standard hypothyroid preparation, prior to remnant ablation with an activity of 3.7 GBq 131 I (11). Applying a pre-defined criterion to measure the success of ablation (i.e.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cost-effectiveness of using recombinant human TSH prior to radioiodine ablation for thyroid cancer, compared with treating patients in a hypothyroid state: the German perspective

Mernagh¹,

Campbell²,

Dietlein³

et al. 2006

eur j endocrinol

View full text Add to dashboard Cite

Objective: This investigation evaluated the cost-effectiveness of radioiodine remnant ablation following preparation with recombinant human TSH (rhTSH), compared with the standard preparation, whereby patients are rendered hypothyroid. Design: The economic evaluation relates to patients with well differentiated thyroid cancer who have undergone thyroidectomy, but have no metastases. The evaluation takes a societal perspective, considering costs and benefits to all parties. The benefits were expressed in units of quality-adjusted life years (QALY), so differences in life expectancy were captured with consideration of quality of life. Methods: A lifetime Markov model with Monte Carlo simulation of 100 000 patients was used to assess cost per QALY gained. The clinical inputs were sourced from a multi-centre, randomised controlled trial comparing remnant ablation success after rhTSH-preparation with hypothyroid preparation. The model applied German unit costs, however, the structure is generalisable to other jurisdictions. The additional cost of rhTSH procurement and administration is considered relative to the clinical benefits and cost offsets. These included avoidance of hypothyroidism, increased work productivity, earlier discharge from radioprotection and a theoretical reduction in the risk of secondary malignancy. The latter two benefits relate to faster radioiodine clearance after rhTSH preparation. Results: The additional benefits of rhTSH (0.0495 QALY) are obtained with an incremental societal cost of V47, equating to an incremental cost per QALY of V958. Sensitivity analyses had only a modest impact upon cost-effectiveness, with all one-way sensitivity results remaining under V15 000/QALY. Conclusions: The use of rhTSH prior to radioiodine ablation represents good value-for-money with the benefits to patient and society obtained at modest net cost. 155 405-414 European Journal of Endocrinology

show abstract

Section: Introductionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of using recombinant human TSH prior to radioiodine ablation for thyroid cancer, compared with treating patients in a hypothyroid state: the German perspective

Mernagh¹,

Campbell²,

Dietlein³

et al. 2006

eur j endocrinol

View full text Add to dashboard Cite

show abstract

“…Radioiodine doses in the range of 90 to 100 mCi 131 I are recommended when rhTSH is administered as an adjuvant before ablation (31,32). However, recent publications have shown that 50 mCi 131 I is equally effective to 100 mCi 131 I for thyroid remnant ablation following rhTSH, with no interruption in L-T 4 administration (33,34).…”

Section: Postoperative Radioiodine Administrationmentioning

confidence: 99%

Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer

Pitoia

Ward

Wohllk

et al. 2009

Arq Bras Endocrinol Metab

126

View full text Add to dashboard Cite

The aims of these recommendations were to develop clinical guidelines for evaluation and management of patients with differentiated thyroid cancer applicable to Latin American countries. The panel was composed by 13 members of the Latin American Thyroid Society (LATS) involved with research and management of thyroid cancer from different medical centers in Latin America. The recommendations were produced on the basis of the expert opinion of the panel with use of principles of Evidence-Based Medicine. Following a group meeting, a first draft based on evidences and the expert opinions of the panel was elaborated and, later, circulated among panel members, for further revision. After, this document was submitted to the LATS members, for commentaries and considerations, and, finally, revised and refined by the authors. The final recommendations presented in this paper represent the state of the art on management of differentiated thyroid cancer applied to all Latin American countries. Arq Bras Endocrinol Metab. 2009;53(7):884-97. KeywordśThyroid cancer; thyroid ultrasonography; radioiodine therapy; thyroglobulin; consensus RESUMO Estas recomendações tiveram por objetivo o desenvolvimento de diretrizes para avaliação e manejo de pacientes com câncer diferenciado da tiroide em países latino-americanos. Um painel composto por 13 membros da Sociedade Latino-Americana de Tireoide (SLAT) -que estavam envolvidos em pesquisas, e eram peritos no cuidado do paciente com câncer da tiroide e provenientes de diferentes centros médicos latino-americanos -utilizou os princípios da Medicina Baseada em Evidências para produzir esse consenso. Após uma primeira reunião, um texto inicial foi elaborado, baseado em evidências e opiniões dos especialistas do painel e, posteriormente, circulado entre os membros do painel, para revisão. Após a revisão, o documento foi enviado aos membros da SLAT para comentários e considerações e, finalmente, revisado e refinado pelos autores. As recomendações finais aqui apresentadas demonstram o estado da arte no manejo do câncer diferenciado da tireoide aplicadas aos países latino-americanos.Arq InTRODUCTIOn T he risk of malignancy in a thyroid nodule varies between 5% and 10% in iodine sufficient countries, and the amount of iodine supplemented in table salt influences on the morphology of the malignant tumor types (1).

show abstract

“…Recent reports clearly demonstrate that rhTSH contributes considerably to reduce the dose to blood and bone marrow by shortening blood and whole-body residence times of 131 I [56][57][58].…”

Section: Therapy For Childhood Thyroid Cancermentioning

confidence: 99%

Childhood Thyroid Cancers and Radioactive Iodine Therapy: Necessity of Precautious Radiation Health Risk Management

et al. 2007

View full text Add to dashboard Cite

Abstract. One of the lessons from Chernobyl's legacy on health impact beyond 20 years is not only how to detect and treat the patients with radiation-associated thyroid cancers but how to follow up those who received radioactive iodine treatment repetitively after surgery in order to monitor any recurrence/worsening and also how to predict the risk of secondary primary cancers for their lifetime period. To evaluate the possibility of second primary tumors after radioactive iodine treatment, we reviewed the reports on risks from both external and internal radiation exposure, especially at high doses during childhood through an internet service of the National Library of Medicine and the National Institutes of Health, PubMed by the end of June, 2007, together with our own experience of Chernobyl childhood thyroid cancers. Children who were internally exposed after Chernobyl accident have a long-term risk of well differentiated thyroid cancers. Once they have disease, ironically radioactive iodine ablation is one of the useful therapies after surgical treatment. Elevated risks of solid cancers and leukemia have been found in radioiodine-treated patients, however, so far precious few reports from Chernobyl thyroid cancer patient were published. To reduce the adverse effects of radioactive iodine therapy on non-target tissues, recombinant human TSH has been applied and proved effective. Period of latency of second primary cancers may be very long. Therefore patients treated with high activities of radioactive iodine, especially children cases, should be carefully followed up during their whole lifespan.

show abstract

Radioiodine Ablation of Thyroid Remnants after Preparation with Recombinant Human Thyrotropin in Differentiated Thyroid Carcinoma: Results of an International, Randomized, Controlled Study

Abstract: This study demonstrates comparable remnant ablation rates in patients prepared for 131I remnant ablation with 3.7 GBq by either administering rhTSH or withholding thyroid hormone. rhTSH-prepared patients maintained a higher quality of life and received less radiation exposure to the blood.

Cited by 392 publications

References 22 publications

Cost-effectiveness of using recombinant human TSH prior to radioiodine ablation for thyroid cancer, compared with treating patients in a hypothyroid state: the German perspective

Cost-effectiveness of using recombinant human TSH prior to radioiodine ablation for thyroid cancer, compared with treating patients in a hypothyroid state: the German perspective

Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer

Childhood Thyroid Cancers and Radioactive Iodine Therapy: Necessity of Precautious Radiation Health Risk Management

Contact Info

Product

Resources

About