Factors That Influence TSH Levels after Thyrogen Injection before RAI Therapy
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Radioactive iodine therapy was used for detection and destruction of remnant normal of malignant thyroid tissue after thyroidectomy for differentiated thyroid gland cancer. To achieve a high level of TSH, discontinuation of levothyroxine is required. Discontinuation of L-T4 causes hypothyroidism, serious adverse impacts on patients, therefore, rhTSH is used. The aim of this study was to evaluate the factors influencing serum peak TSH levels after administration of rhTSH in patients with thyroid papillary carcinoma. Methods: Retrospective review was conducted of 249 patients who underwent total thyroidectomy and subsequent RAI therapy at Kangbuk Samsung Hospital between October 2008 and February 2014. We divided patients into two groups according to the stimulated serum TSH level after administration of rhTSH (Group 1: TSH ＜30, Group 2: TSH≥30). Clinicopathological characteristics were compared between the two groups. Results: Serum peak TSH was negatively related to height, weight, BSA, and BMI, and positively related to LBM. A non-significant negative correlation was found between serum peak TSH and body composition. Conclusion: Patients’ weight, height, BMI, BSA, and LBM were not associated with serum peak TSH after rhTSH administration. More pharmakokinetic study of rhTSH is needed in order to find correlation between pharmacokinetic factors and TSH level.
Abstract
Purpose: Radioactive iodine therapy was used for detection and destruction of remnant normal of malignant thyroid tissue after thyroidectomy for differentiated thyroid gland cancer. To achieve a high level of TSH, discontinuation of levothyroxine is required. Discontinuation of L-T4 causes hypothyroidism, serious adverse impacts on patients, therefore, rhTSH is used. The aim of this study was to evaluate the factors influencing serum peak TSH levels after administration of rhTSH in patients with thyroid papillary carcinoma. Methods: Retrospective review was conducted of 249 patients who underwent total thyroidectomy and subsequent RAI therapy at Kangbuk Samsung Hospital between October 2008 and February 2014. We divided patients into two groups according to the stimulated serum TSH level after administration of rhTSH (Group 1: TSH ＜30, Group 2: TSH≥30). Clinicopathological characteristics were compared between the two groups. Results: Serum peak TSH was negatively related to height, weight, BSA, and BMI, and positively related to LBM. A non-significant negative correlation was found between serum peak TSH and body composition. Conclusion: Patients’ weight, height, BMI, BSA, and LBM were not associated with serum peak TSH after rhTSH administration. More pharmakokinetic study of rhTSH is needed in order to find correlation between pharmacokinetic factors and TSH level.
참고문헌 (30)
- Billewicz WZ, "Statistical methods applied to the diagnosis of hypothyroidism", Q J Med, 38, pp.255~266 (1969)
- Meier CA, "Diagnostic use of recombinant human thyrotropin in patients with thyroid carcinoma (phase I", II study), 1994, pp.78, 188~196
- Luster M, "Thyroid hormone withdrawal in patients with differentiated thyroid carcinoma: a one hundred thirty-patient pilot survey on consequences of hypothyroidism and a pharmacoeconomic comparison to recombinant thyrotropin administration", Thyroid, 15, pp.1147~1155 (2005)
- Burke G, "The thyrotrophin stimulation test", Ann Intern Med, 69, pp.1127~1139 (1968)
- Taunton OD, "Standardization of tsh testing", J Clin Endocrinol Metab, 25, pp.266~277 (1965)
- Kirkpatrick CH, "Mechanism of allergy to components of commercial bovine thyrotropin", J Allergy Clin Immunol, 51, pp.296~302 (1973)
- Krishnamurthy GT, "Human reaction to bovine TSH: concise communication", J Nucl Med, 19, pp.284~286 (1978)
- Wondisford FE, "Isolation and characterization of the human thyrotropin beta-subunit gene. Differences in gene structure and promoter function from murine species", J Biol Chem, 263, pp.12538~12542 (1988)
- Huber GK, "Recombinant human thyroid-stimulating hormone: initial bioactivity assessment using human fetal thyroid cells", J Clin Endocrinol Metab, 72, pp.1328~1331 (1991)
- Vitale G, "Influence of body surface area on serum peak thyrotropin (TSH) levels after recombinant human TSH administration", J Clin Endocrinol Metab, 88, pp.1319~1322 (2003)
- Castagna MG, "Influence of human body composition on serum peak thyrotropin (TSH) after recombinant human TSH administration in patients with differentiated thyroid carcinoma", J Clin Endocrinol Metab, 90, pp.4047~4050 (2005)
- Ladenson PW, "Comparison of administration of recombinant human thyrotropin with withdrawal of thyroid hormone for radioactive iodine scanning in patients with thyroid carcinoma", N Engl J Med, 337, pp.888~896 (1997)
- Haugen BR, "A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer", J Clin Endocrinol Metab, 84, pp.3877~3885 (1999)
- Edmonds CJ, "Measurement of serum TSH and thyroid hormones in the management of treatment of thyroid carcinoma with radioiodine", Br J Radiol, 50, pp.799~807 (1977)
- McDougall IR, "Recombinant human thyrotropin in the management of thyroid cancer", Curr Opin Oncol, 13, pp.39~43 (2001)
- Kohlfuerst S, "Recombinant human thyrotropin is helpful in the follow-up and 131I therapy of patients with thyroid cancer: a report of the results and benefits using recombinant human thyrotropin in clinical routine", Thyroid, 15, pp.371~376 (2005)
- Luster M, "Thyroid hormone withdrawal in patients with differentiated thyroid carcinoma: a one hundred thirty-patient pilot survey on consequences of hypothyroidism and a pharmacoeconomic comparison to recombinant thyrotropin administration", Thyroid, 15, pp.1147~1155 (2005)
- Schroeder PR, "A comparison of short-term changes in health-related quality of life in thyroid carcinoma patients undergoing diagnostic evaluation with recombinant human thyrotropin compared with thyroid hormone withdrawal", J Clin Endocrinol Metab, 91, pp.878~884 (2006)
- Hänscheid H, "Iodine biokinetics and dosimetry in radioiodine therapy of thyroid cancer: procedures and results of a prospective international controlled study of ablation after rhTSH or hormone withdrawal", J Nucl Med, 47, pp.648~654 (2006)
- Borget I, "Length and cost of hospital stay of radioiodine ablation in thyroid cancer patients: comparison between preparationwith thyroid hormone withdrawal and thyrogen", Eur J Nucl Med Mol Imaging, 35, pp.1457~1463 (2008)
- Ladenson PW, "Comparison of administration of recombinant human thyrotropin with withdrawal of thyroid hormone for radioactive iodine scanning in patients with thyroid carcinoma", N Engl J Med, 337, pp.888~896 (1997)
- Pacini F, "Preparation with thyrotropin is equivalent to thyroid hormone withdrawal as preparation for thyroid remnant ablation in differentiated thyroid carcinoma", Turk J Endocrinol Metab, 8(Suppl 1), pp.21~ (2004)
- Morgan DJ, "Lean body mass as a predictor of drug dosage. Implications for drug therapy", Clin Pharmacokinet, 26, pp.292~307 (1994)
- Roubenoff R, "The meaning and measurement of lean body mass", Nutr Rev, 49, pp.163~175 (1991)
- Thotakura NR, "Biological activity and metabolic clearance of a recombinant human thyrotropin produced in Chinese hamster ovary cells", Endocrinology, 128, pp.341~348 (1991)
- Goslings BM, "Proceedings: Effect of a low iodine diet on 131-I therapy in follicular thyroid carcinomata", J Endocrinol, 64, pp.30~ (1975)
- Tomoda C, "Reevaluation of stringent low iodine diet in outpatient preparation for radioiodine examination and therapy", Endocr J, 52, pp.237~240 (2005)
- Barbaro D, "Radioiodine treatment with 30 mCi after recombinant human thyrotropin stimulation in thyroid cancer: effectiveness for postsurgical remnants ablation and possible role of iodine content in L-thyroxine in the outcome of ablation", J Clin Endocrinol Metab, 88, pp.4110~4115 (2003)
- Park SG, "Iodine kinetics during 131-I scanning in patients with thyroid cancer: comparison of studies with recombinant human TSH (rhTSH) vs. hypothyroidism", J Nucl Med, 37(abstr), pp.15~ (1996)
- Kogai T, "Regulation by thyroid-stimulating hormone of sodium", iodide symporter gene expression and protein levels in FRTL-5 cells, 1997, pp.138, 2227~2232