Background: Recombinant human TSH (rhTSH) has become the modality of choice for radioiodine remnant ablation of residual thyroid cancer tissue in low-risk patients.
Methods: The FACIT-F was administered from the early postoperative period to 9 months. Socio-demographic parameters, anxiety and depression scales were also evaluated. At 24 h, 48 h and d6 post-therapy, dose rate were measured. Using a simplified model, radiation exposure to public was estimated in both groups. At 9 months, patients underwent an rhTSH stimulation test, diagnostic 131-Iodine whole body scan (dxWBS) and neck ultrasonography.
Results: About 74 patients were enrolled in the study. There was a significant decrease in QoL from baseline (t0) to t1 (RRA period) in the hypothyroid group with significant differences in FACIT-F TOI (P<10-3), FACT-G total score (P=0.005) and FACIT-F total score (P=0.003). By contrast, QoL was preserved in the rhTSH group. In the mulivariate analysis, FACIT-TOI changes were only affected by the modality of TSH stimulation performed for RRA. No difference in ablation success was observed between rhTSH and hypothyroidism groups, 91.7% and 97.1% respectively. A higher rate of persistant thyroid remnants was observed in the rhTSH arm, although in most cases uptake was <0.1% and of no clinical significance. At 48 h, dose rate were lower in the rhTSH-group. Radiation exposure to public is also reduced in the rhTSH arm.
Conclusions: rhTSH preserves QoL of patients undergoing RRA with similar rates of ablation success compared to hypothyrodism. The use of rhTSH decreases the duration of hospitalization and is in line with the current legislation.