Recombinant human TSH use in differentiated thyroid cancer
Date
2007
Authors
Graf, Hans
Da Paz Filho, Gilberto
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Universidade de Sao Paulo, Faculdade de Medicina
Abstract
Traditionally, the immediate treatment of patients with differentiated thyroid carcinoma (DTC) after total thyroidectomy (TT) is thyroid remnant ablation (TRA) with131I, during hypothyroidism. Late follow-up of DCT includes suppressive doses of T4, serial measurements of thyroglobulin (Tg), whole body scan (WBS) with131I and cervical ultrasound (US). In the last years, TRA with the aid of recombinant human TSH (rhTSH) has shown not only to avoid symptoms of hypothyroidism and a lower quality of life, but also to have the same efficacy as TRA during endogenous TSH elevation. Stimulated Tg with endogenous or exogenous TSH, 9 to 12 months after the initial treatment of DTC, associated with cervical US, is able to identify low-risk patients virtually cured of their disease, in whom TSH suppression does not need to be so strict, avoiding the heart and bone complications of prolonged exogenous thyrotoxicosis. Finally, in spite of the absence of randomized studies designed to evaluate the role of rhTSH in metastatic DTC disease, results of the combined treatment of rhTSH and131I show a clinical benefit in the majority of treated patients.
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Keywords: radioactive iodine; recombinant protein; thyrotropin; adenocarcinoma; human; papillary carcinoma; review; thyroid tumor; thyroidectomy; tumor recurrence; Adenocarcinoma, Follicular; Carcinoma, Papillary; Humans; Iodine Radioisotopes; Neoplasm Recurrence, Cancer; Recombinant human TSH; Thyroid
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Arquivos Brasileiros de Endocrinologia e Metabologia
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Journal article
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2037-12-31
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