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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.

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 (131)I-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.
AuthorsKyoungjune Pak, Gi Jeong Cheon, Keon Wook Kang, Seong-Jang Kim, In-Joo Kim, E Edmund Kim, Dong Soo Lee, June-Key Chung
JournalJournal of Korean medical science (J Korean Med Sci) Vol. 29 Issue 6 Pg. 811-7 (Jun 2014) ISSN: 1598-6357 [Electronic] Korea (South)
PMID24932083 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
Chemical References
  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • Recombinant Proteins
  • Thyrotropin
  • Thyroglobulin
Topics
  • 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 (diagnostic imaging, drug therapy)
  • Thyrotropin (genetics, metabolism, therapeutic use)
  • Treatment Outcome
  • Ultrasonography
  • Whole Body Imaging

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