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An easy schedule for postsurgical radioiodine administration in newly diagnosed differentiated thyroid carcinoma patients
Author(s) -
Lupoli Gelsy A.,
Poggiano Maria R.,
Panico Annalisa,
Granieri Luciana,
Lupoli Roberta,
Cacciapuoti Marianna,
Lupoli Giovanni
Publication year - 2013
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12004
Subject(s) - medicine , group b , thyroid carcinoma , group a , thyroidectomy , thyroid , radioiodine therapy , gastroenterology , endocrinology , urology , surgery
Summary Objective To validate the simplest approach to preparing patients with differentiated thyroid carcinoma ( DTC ) for 131 I ‐administration ( 131 I ‐ A ), minimizing the impact of hypothyroidism. Design Panel study. Patients Ninety patients with DTC were enrolled in the study. Sixty (Group A) underwent total thyroidectomy ( TT ); L‐T4 was not administered in preparation for 131 I ‐ A planned for 3 weeks later. Thirty patients (Group B) with previous TT and 131 I ‐ A stopped L‐T4 in preparation for clinical evaluation, including whole‐body scanning ( WBS )/radioiodine therapy during thyrotrophin ( TSH ) stimulation planned for 3 weeks (or more) later. Measurements Thyrotrophin was measured the day before TT for group A, during L‐T4 for group B (baseline‐time 1) and then every week until it reached ≥30 mIU/l (time 2). Quality of life ( Q o L ) was evaluated by Billewicz index. Results At week 3, 100% of patients in group A and 56·6% of group B exceeded TSH > 30 mIU/l. In group B, the cut‐off was achieved in four patients at the fourth week ( TSH 38·6 ± 8·7 mIU/l), in 3 at the fifth (53·2 ± 3) and in 6 at the sixth (42·3 ± 6·1). From time 1 to time 2, total Q o L scores were less affected in group A (percentage decrease: 105%) than in group B (218%). At time 2, the total score was >+19 in group A in 46 patients and in 30 in group B. In group A, TSH levels in the higher tertile of Q o L (61 ± 6 mIU/l) were not different from those in the lower tertile (62·3 ± 11·1)( P > 0·1); similar results were seen in group B (69·3 ± 13·3 vs 62·9 ± 13·1)( P > 0·1). There was a positive correlation between the time to obtain TSH ≥ 30 mIU/l and total Q o L scores. Conclusions Quality of life scores were not affected by thyrotrophin was measured the day before TT levels as absolute values. A longer time to obtain TSH ≥ 30 mIU/l was positively correlated with worse scores of Q o L . We suggest 3 weeks without therapy can be used as an easy schedule in patients who undergo TT for DTC.