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Meta-Analysis
. 2014 Jun;29(6):811-7.
doi: 10.3346/jkms.2014.29.6.811. Epub 2014 May 30.

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

Kyoungjune Pak  1 , Gi Jeong Cheon  2 , Keon Wook Kang  2 , Seong-Jang Kim  3 , In-Joo Kim  3 , E Edmund Kim  4 , Dong Soo Lee  5 , June-Key Chung  2
Affiliations
Meta-Analysis

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

Kyoungjune Pak et al. J Korean Med Sci. 2014 Jun.

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.

Keywords: Thyroid Neoplasms; Thyrotropin Alfa.

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Conflict of interest statement

No potential conflict of interest relevant to this article.

Figures

Fig. 1
Fig. 1
Flow chart of the selection process.
Fig. 2
Fig. 2
Comparison of ablation success, as defined by a Tg cutoff value of 1 ng/mL (A), and by a Tg cutoff value of 1 ng/mL plus imaging modality (B), between recombinant human thyroid stimulating hormone (rhTSH) and thyroid hormone withdrawal (THW).
Fig. 3
Fig. 3
Comparison of ablation success, as defined by a Tg cutoff value of 2 ng/mL (A), and by a Tg cutoff value of 2 ng/mL plus imaging modality (B), between recombinant human thyroid stimulating hormone (rhTSH) and thyroid hormone withdrawal (THW).
Fig. 4
Fig. 4
Comparison of ablation success, as defined by the 131I-whole body scan (WBS), between recombinant human thyroid stimulating hormone (rhTSH) and thyroid hormone withdrawal (THW).
See this image and copyright information in PMC

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