The Effectiveness of Recombinant Human Thyroid-Stimulating Hormone versus Thyroid Hormone Withdrawal Prior to Radioiodine Remnant Ablation in Thyroid Cancer: A Meta-Analysis of Randomized Controlled Trials.
10.3346/jkms.2014.29.6.811
- Author:
Kyoungjune PAK
1
;
Gi Jeong CHEON
;
Keon Wook KANG
;
Seong Jang KIM
;
In Joo KIM
;
E Edmund KIM
;
Dong Soo LEE
;
June Key CHUNG
Author Information
1. Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea. larrycheon@gmail.com
- Publication Type:Original Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't
- Keywords:
Thyroid Neoplasms;
Thyrotropin Alfa
- MeSH:
Catheter Ablation;
Clinical Trials as Topic;
Databases, Factual;
Humans;
Iodine Radioisotopes/*therapeutic use;
Radiopharmaceuticals/*therapeutic use;
Recombinant Proteins/biosynthesis/genetics/therapeutic use;
Risk;
Thyroglobulin/analysis/metabolism;
Thyroid Neoplasms/*drug therapy/ultrasonography;
Thyrotropin/genetics/metabolism/*therapeutic use;
Treatment Outcome;
Whole Body Imaging
- From:Journal of Korean Medical Science
2014;29(6):811-817
- CountryRepublic of Korea
- Language:English
-
Abstract:
We evaluated the efficacy of recombinant human thyroid-stimulating hormone (rhTSH) versus thyroid hormone withdrawal (THW) prior to radioiodine remnant ablation (RRA) in thyroid cancer. A systematic search of MEDLINE, EMBASE, the Cochrane Library, and SCOPUS was performed. Randomized controlled trials that compared ablation success between rhTSH and THW at 6 to 12 months following RRA were included in this study. Six trials with a total of 1,660 patients were included. When ablation success was defined as a thyroglobulin (Tg) cutoff of 1 ng/mL (risk ratio, 0.99; 95% confidence interval, 0.96-1.03) or a Tg cutoff of 1 ng/mL plus imaging modality (RR 0.97; 0.90-1.05), the results of rhTSH and THW were similar. There were no significant differences when ablation success was defined as a Tg cutoff of 2 ng/mL (RR 1.03; 0.95-1.11) or a Tg cutoff of 2 ng/mL plus imaging modality (RR 1.02; 0.95-1.09). When a negative 131I-whole body scan was used solely as the definition of ablation success, the effects of rhTSH and THW were not significantly different (RR 0.97; 0.93-1.02). Therefore, ablation success rates are comparable when RRA is prepared by either rhTSH or THW.
