The effect of recombinant human thyroid stimulating hormone on sustaining liver and renal function in thyroid cancer patients during radioactive iodine therapy

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Abstract

Objective

The aim of this study was to evaluate the effect of recombinant human thyroid stimulating hormone (rhTSH) on sustaining liver and renal function in thyroid cancer patients during radioiodine therapy (RIT).

Patients and methods

This study was conducted as a retrospective investigation between January 2005 and April 2012. Ninety-eight thyroid cancer patients who were treated with RIT using both thyroid hormone withdrawal (THW) and rhTSH were enrolled. The levels of cholesterol, aspartate aminotransaminase (AST), alanine transaminase (ALT), and serum creatinine (Cr) were analyzed before and after each RIT.

Results

The cholesterol level before RIT with rhTSH was significantly lower than that after RIT with rhTSH (P<0.001). The cholesterol level increased before RIT with THW and decreased to within a normal range after RIT with THW (P<0.001). AST and ALT levels before RIT with THW were significantly higher than those before RIT with rhTSH (P<0.001). The serum Cr level before RIT with THW was higher than that before RIT with rhTSH (P<0.001). No significant differences in the serum values of AST, ALT, and Cr after RIT were observed between the THW and rhTSH groups. The remaining iodine was used to estimate radioiodine clearance and renal function indirectly. In 72 patients treated with the same activity of 131I for THW and rhTSH, the mean counts of regions of interest in the rhTSH group were significantly lower than those in the THW group (P<0.001).

Conclusion

rhTSH administration can sustain liver and renal function in thyroid cancer patients during RIT. Moreover, the use of rhTSH reduces unnecessary radiation exposure.

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