Combined treatment of the highly differentiated cancer of thyroid gland: recombinant human thyrotropin-alpha is in the focus
DOI:
https://doi.org/10.15587/2313-8416.2016.64975Keywords:
highly differentiated cancer of thyroid gland, recombinant human thyrotropin-alpha, life quality, thyroglobulin, ablation, radioiodine therapyAbstract
Aim. An assessment of the effectiveness of treatment and also the detection of advantages of prescription of the recombinant human thyrotropin-alpha (rhTTH) in postoperative period in patients with the highly differentiated cancer of thyroid gland (HDCTG) comparing with traditional method of preparation (cancellation of the thyroid hormones) to the treatment using radioactive iodine.
Methods. There was carried out an analysis of the treatment of 100 patients with HDCTG: the control group – 56 patients (standard tactics), the main group – 44 patients (the use of rhTTH). There was carried out the scanning of all the body in 48 hours after administration of 150 MBc 131I, was detected the concentration of thyroglobulin and antibodies to it, the level of thyrotropic hormone, was carried out the ultrasound of neck and also questioning about the life quality.
Results. The comparative analysis of the data of studied groups demonstrated the reliably less number of isotope accumulation nidi in persons whose preparation was carried out with the help of rhTTH, that is the absence of visible catch in 25 % of cases in patients from the category of low risk (in 5,7 times higher than in analogous cohort of the control group– 4,4 %) and in 7,1 % – in patients from the high risk group. The number of cases of the minimal visible catch <0,1 % in patients of the high risk category is reliably higher comparing with the control one (78,1 % and 56,1 % respectively, Р<0,01). The level of stimulated serum thyroglobulin >2,0 ng/ml was detected in 3,1 % of cases in the main group whereas in the control one – 13,1 %; within 1,0–2,0 ng/ml was detected reliably less often in the main group: 8,3 % in the low risk patients and 12,5 % – in the high risk ones comparing with the control group (28,6 % and 31,7 % respectively). The effective decrease of thyroglobulin level in 6–8 months after radioiodine therapy was detected in 22 (91,7 %) patients of the main low risk group and in 27 (84,4 %) – ones of the high risk that is reliably higher than in the control group (60,0 % and 53,7 % respectively, Р<0,01). In the main group was not observed any clinical relapse of disease or persistence of pathological tumor process, in the control group on the contrary – 2 clinical relapses (4,9 %) and 4 cases (9,7 %) of persistence of disease. In the main group nobody needed the repeated operation during 6 months after radioiodine therapy because of absence of the regional metastases of papillary carcinoma. The negative assessment of health was observed in 10,7 % of cases in the control group and was not fixed in the main one. The positive assessment of health was observed in 63,6 % of patient who took recombinant TTH comparing with the control group – 21,4 %.
Conclusions. The research demonstrated that combined treatment of the group of patients with HDCTG with the use of rhTTH is reliably more effective comparing with the group of patients who were prepared to treatment with the radioactive iodine using traditional method. The received results ground by the new proofs the advantages of the use of recombinant human thyrotropin-alpha
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