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Long-term outcome of low-activity radioiodine administration preceded by adjuvant recombinant human TSH pretreatment in elderly subjects with multinodular goiter.

Giusti M, Caputo M, Calamia I, Bagnara M, Ceresola E, Schiavo M, Mussap M, Ferone D, Minuto F, Bagnasco M - Thyroid Res (2009)

Bottom Line: While TV was reduced in both groups, the percentage TV reduction recorded at the last examination was significantly higher (P = 0.03) in group 1 than in group 2.MNG-related complaints were significantly reduced in both group 1 (P = 0.0001 vs baseline) and group 2 (P = 0.001) patients.Low radioiodine activities after pretreatment with low-dosage rhTSH are able to reduce TV and improve MNG-related symptoms in elderly subjects.

View Article: PubMed Central - HTML - PubMed

Affiliation: Clinica Endocrinologica, Azienda Ospedaliera Universitaria "San Martino", Genoa, Italy. magius@unige.it.

ABSTRACT

Background: Large multinodular goiter (MNG) in elderly people is a common finding which can require intervention. The long-term effect of radioiodine therapy on thyroid volume (TV) and function after recombinant human (rh) TSH pre-treatment was evaluated.

Methods: After baseline evaluation, 40 subjects over 60 years old with a large MNG were treated with 131I up to the activity of 600 MBq. Nineteen patients were pretreated with rhTSH (0.1 mg on 2 consecutive days; group 1) while 21 subjects underwent treatment without rhTSH pretreatment (group 2). TV was monitored every 6-12 months by ultrasonography. The median follow-up period was 36 months.

Results: At the baseline, the groups matched in terms of TV, 24-h radioiodine uptake (RAIU), urinary iodine and neck complaints. The number of subjects pretreated with anti-thyroid drugs was significantly (P = 0.01) greater in group 2 than in group 1; TSH was more suppressed (P = 0.003) and f-T3 was more elevated (P = 0.005) in group 2 than in group 1 patients. RhTSH increased 24-h RAIU in group 1 up to the baseline level observed in group 2. The 131I activity administered was similar in both groups. Adverse events were slight and similar in both groups. A permanent post-radioiodine toxic condition was reported only in 2 patients in group 2. After radioiodine therapy, hypothyroidism was observed in significantly more group 1 patients than group 2 patients (P = 0.002). While TV was reduced in both groups, the percentage TV reduction recorded at the last examination was significantly higher (P = 0.03) in group 1 than in group 2. MNG-related complaints were significantly reduced in both group 1 (P = 0.0001 vs baseline) and group 2 (P = 0.001) patients.

Conclusion: Low radioiodine activities after pretreatment with low-dosage rhTSH are able to reduce TV and improve MNG-related symptoms in elderly subjects.

No MeSH data available.


Related in: MedlinePlus

Mean (± SEM) scores self-reported by patients by means of an ad hoc VAS scale administered to all patients at the baseline (closed bars) and at the last examination (open bars).
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Figure 3: Mean (± SEM) scores self-reported by patients by means of an ad hoc VAS scale administered to all patients at the baseline (closed bars) and at the last examination (open bars).

Mentions: Figure 3 reports mean VAS scores on enrolment and at the last examination. At the baseline, no difference in VAS scores was noted between the groups. In both groups, baseline VAS scores were unrelated to TV. At the last examination, VAS scores were significantly reduced in both groups of patients but the reduction from the baseline was more significant in group 1 (P = 0.0001) than in group 2 (P = 0.001) patients (Figure 3). No change (n = 2) or a slight reduction (n = 2) in VAS score was noted in the 4 group 2 patients who dropped out of the study 24 months after RAI in order to undergo further RAI treatment or thyroidectomy.


Long-term outcome of low-activity radioiodine administration preceded by adjuvant recombinant human TSH pretreatment in elderly subjects with multinodular goiter.

Giusti M, Caputo M, Calamia I, Bagnara M, Ceresola E, Schiavo M, Mussap M, Ferone D, Minuto F, Bagnasco M - Thyroid Res (2009)

Mean (± SEM) scores self-reported by patients by means of an ad hoc VAS scale administered to all patients at the baseline (closed bars) and at the last examination (open bars).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2713215&req=5

Figure 3: Mean (± SEM) scores self-reported by patients by means of an ad hoc VAS scale administered to all patients at the baseline (closed bars) and at the last examination (open bars).
Mentions: Figure 3 reports mean VAS scores on enrolment and at the last examination. At the baseline, no difference in VAS scores was noted between the groups. In both groups, baseline VAS scores were unrelated to TV. At the last examination, VAS scores were significantly reduced in both groups of patients but the reduction from the baseline was more significant in group 1 (P = 0.0001) than in group 2 (P = 0.001) patients (Figure 3). No change (n = 2) or a slight reduction (n = 2) in VAS score was noted in the 4 group 2 patients who dropped out of the study 24 months after RAI in order to undergo further RAI treatment or thyroidectomy.

Bottom Line: While TV was reduced in both groups, the percentage TV reduction recorded at the last examination was significantly higher (P = 0.03) in group 1 than in group 2.MNG-related complaints were significantly reduced in both group 1 (P = 0.0001 vs baseline) and group 2 (P = 0.001) patients.Low radioiodine activities after pretreatment with low-dosage rhTSH are able to reduce TV and improve MNG-related symptoms in elderly subjects.

View Article: PubMed Central - HTML - PubMed

Affiliation: Clinica Endocrinologica, Azienda Ospedaliera Universitaria "San Martino", Genoa, Italy. magius@unige.it.

ABSTRACT

Background: Large multinodular goiter (MNG) in elderly people is a common finding which can require intervention. The long-term effect of radioiodine therapy on thyroid volume (TV) and function after recombinant human (rh) TSH pre-treatment was evaluated.

Methods: After baseline evaluation, 40 subjects over 60 years old with a large MNG were treated with 131I up to the activity of 600 MBq. Nineteen patients were pretreated with rhTSH (0.1 mg on 2 consecutive days; group 1) while 21 subjects underwent treatment without rhTSH pretreatment (group 2). TV was monitored every 6-12 months by ultrasonography. The median follow-up period was 36 months.

Results: At the baseline, the groups matched in terms of TV, 24-h radioiodine uptake (RAIU), urinary iodine and neck complaints. The number of subjects pretreated with anti-thyroid drugs was significantly (P = 0.01) greater in group 2 than in group 1; TSH was more suppressed (P = 0.003) and f-T3 was more elevated (P = 0.005) in group 2 than in group 1 patients. RhTSH increased 24-h RAIU in group 1 up to the baseline level observed in group 2. The 131I activity administered was similar in both groups. Adverse events were slight and similar in both groups. A permanent post-radioiodine toxic condition was reported only in 2 patients in group 2. After radioiodine therapy, hypothyroidism was observed in significantly more group 1 patients than group 2 patients (P = 0.002). While TV was reduced in both groups, the percentage TV reduction recorded at the last examination was significantly higher (P = 0.03) in group 1 than in group 2. MNG-related complaints were significantly reduced in both group 1 (P = 0.0001 vs baseline) and group 2 (P = 0.001) patients.

Conclusion: Low radioiodine activities after pretreatment with low-dosage rhTSH are able to reduce TV and improve MNG-related symptoms in elderly subjects.

No MeSH data available.


Related in: MedlinePlus