Recombinant human thyroid-stimulating hormone in radioiodine thyroid remnant ablation

To prevent the unwarranted effects of post-thyroidectomy hypothyroidism prior to radiodine (RAI) ablation, patients with well-differentiated thyroid cancer can currently undergo this treatment while in a euthyroid state. This is achieved with the use of recombinant human thyroid-stimulating hormone (rhTSH) injections prior to the ablation.

To demonstrate the efficacy of rhTSH in radioiodine thyroid ablation in patients with differentiated thyroid cancer.

We conducted a retrospective study of patients who underwent total thyroidectomy for well-differentiated thyroid cancer with different levels of risk, treated with rhTSH prior to remnant ablation with radioiodine.

Seventeen patients with thyroid cancer were studied and followed fora median of 25 months (range 8-49 months). Ablation (defined as stimulated thyroglobulin < 1 mg/ml and negative neck ultrasonography) was successful in 15 patients (88.2%). One of the patients was lost to follow-up.

The use of rhTSH with postoperative radioiodine ablation may be an efficient tool for sufficient thyroid remnant ablation, avoiding hypothyroidal state in the management of thyroid cancer patients.