USE OF RECOMBINANT HUMAN TSH IN THYROID CANCER PATIENTS

目前，接受近全甲状腺切除术的高分化甲状腺癌患者，如果在扫描中发现甲状腺残留和/或转移，通常需要进行全身I131扫描和I131治疗。在这些治疗之前，标准护理要求停止甲状腺激素替代，以刺激内源性TSH分泌，以优化残留甲状腺组织和/或转移对I131的摄取。这种方法对于患有充血性心力衰竭等疾病的患者可能是危险的，这些疾病可能会受到长期甲状腺功能减退的不利影响。本研究的目的是为甲状腺癌患者提供重组TSH（甲状腺激素）注射，以避免长期的甲状腺功能减退，然后进行甲状腺扫描，以指导和治疗残余甲状腺癌。作为重组技术的产物，Thryrogen可以支持tsh依赖性代谢活动，而不被认为是抗原实体。到目前为止，已有两名患者根据该方案成功地接受了甲状腺激素治疗。两组患者均未出现任何不良反应，并且两组患者在全身扫描和I131治疗时均可看到残留和/或转移性甲状腺组织。

At the present time, patients with well differentiated thyroid cancer who have undergone a near total thyroidectomy are frequently subjected to a total body I131 scan and I131 treatment if thyroid remnants and/or metastasis are identified on the scan. Prior to these treatments, the standard of care requires withdrawal of thyroid hormone replacement to stimulate endogenous TSH secretion needed to optimize I131 uptake by residual thyroid tissue and/or metastasis. This approach may be hazardous in patients with medical conditions such as congestive heart failures, which may be adversely affected by a prolonged state of hypothyroidism. The purpose of this study is to offer patients with thyroid cancer an injection of recombinant TSH (Thyrogen) to avoid prolonged hypothyroidism prior to obtaining a thyroid scan for the direction and treatment of residual thyroid cancer. As a product of recombinant technology, Thryrogen could support TSH-dependent metabolic activities without being recognized as an antigenic entity. Until now, two patients have been successfully treated with thyrogen according to this protocol. Neither experienced any adverse reaction and in both thyrogen administration allowed visualization of residual and/or metastatic thyroid tissue on total body scan and treatment with I131.