Purpose: The use of recombinant TSH (Thyrogen) has already entered in the clinical routine in order to avoid the discomfort and the morbidity associated with the withdraw of the thyroid hormone.
Methods and Materials: We used the recombinant human TSH in 20 patients (age>50 years) totally or near totally thyroidectomized who came in our clinic to receive radioiodine therapy for locally invasive differentiated thyroid cancer. All patients were treated, while euthyroid on L-4, after rhTSH administration with to consecutive daily injections (0.9 mg) of rhTSH. Half of them underwent diagnostic before therapy diagnostic whole body scan using again rhTSH administration and after that iodine therapy using an identical second course of rhTSH.
Results: Administration of Thyrogen promoted I-131 therapy uptake in all patients as demonstrated with the post-therapeutic whole body scan. As known the administration of rhTSH increase the sensitivity of the Tg (thyrogobulin) concentrations measurements. About 12 months after therapy we performed whole body I-131 scan and we show a complete remission of the residual sites and in two patients reduction in one metastatic site.
Conclusion: Administration of rhTSH is safe and a very useful tool for inducing I-131 uptake in local or metastatic differentiated thyroid cancer avoiding L-T4 withdrawal.