Abstract Title:

Thyroid-hormone therapy and thyroid cancer: a reassessment.

Abstract Source:

Nat Clin Pract Endocrinol Metab. 2005 Nov;1(1):32-40. PMID: 16929364

Abstract Author(s):

Bernadette Biondi, Sebastiano Filetti, Martin Schlumberger

Article Affiliation:

Department of Clinical and Molecular Endocrinology and Oncology, University of Naples Federico II, Naples, Italy. bebiondi@unina.it

Abstract:

Experimental studies and clinical data have demonstrated that thyroid-cell proliferation is dependent on thyroid-stimulating hormone (TSH), thereby providing the rationale for TSH suppression as a treatment for differentiated thyroid cancer. Several reports have shown that hormone-suppressive treatment with the L-enantiomer of tetraiodothyronine (L-T(4)) benefits high-risk thyroid cancer patients by decreasing progression and recurrence rates, and cancer-related mortality. Evidence suggests, however, that complex regulatory mechanisms (including both TSH-dependent and TSH-independent pathways) are involved in thyroid-cell regulation. Indeed, no significant improvement has been obtained by suppressing TSH in patients with low-risk thyroid cancer. Moreover, TSH suppression implies a state of subclinical thyrotoxicosis. In low-risk patients, the goal of L-T(4) treatment is therefore to obtain a TSH level in the normal range (0.5-2.5 mU/l). Only selected patients with high-risk papillary and follicular thyroid cancer require long-term TSH-suppressive doses of L-T(4). In these patients, careful monitoring is necessary to avoid undesirable effects on bone and heart.

Study Type : Review
Additional Links
Problem Substances : Thyroxine : CK(146) : AC(24)

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