Abstract
Treatment with thyroid hormone is needed in patients with differentiated thyroid carcinoma (DTC) after the initial treatment (thyroidectomy followed, in most cases, by radioiodine remnant ablation) for two reasons: a) Correction of hypothyroidism in an athyreotic patient (replacement therapy); b) Blockade of thyrotropin (TSH) secretion in view of the TSH-dependence of DTC (TSH-suppressive therapy). Levothyroxine (L-T4) is the hormone of choice, since combination with levotriiodothyronine does not add any clear advantage with respect to L-T4 monotherapy. While replacement therapy obviously is a lifelong requirement, duration of TSH-suppressive therapy depends on the tumor risk stratification after and the response to the initial treatment. According to recent European and American guidelines, in low-risk DTC LT4 treatment should be carried out at TSH-suppressive doses until there is evidence that the patient is disease-free. In high-risk DTC, TSH suppression should be maintained for several years after such an evidence has been achieved. Afterwards, the patient can be shifted to replacement doses, also to avoid the risks of iatrogenic thyrotoxicosis, especially in the elderly and/or in the presence of cardiovascular disease. The dose of L-T4 must be invidualized; particular attention must be given to the coexistence of pathophysiological conditions or drug treatments that may affect L-T4 absorption or metabolism.
Keywords: Differentiated thyroid carcinoma, L-thyroxine, Thyrotropin, Thyrotropin suppression, Free thyroxine
Current Cancer Therapy Reviews
Title: Thyroid Hormone Treatment for Differentiated Thyroid Carcinoma: What Drug, How Long, What Dose?
Volume: 5 Issue: 4
Author(s): Eliana Piantanida, Emanuele Compri, Myriam Gandolfo, Lorenza Sassi, Gianlorenzo Dionigi, Adriana Lai, Maria Laura Tanda and Luigi Bartalena
Affiliation:
Keywords: Differentiated thyroid carcinoma, L-thyroxine, Thyrotropin, Thyrotropin suppression, Free thyroxine
Abstract: Treatment with thyroid hormone is needed in patients with differentiated thyroid carcinoma (DTC) after the initial treatment (thyroidectomy followed, in most cases, by radioiodine remnant ablation) for two reasons: a) Correction of hypothyroidism in an athyreotic patient (replacement therapy); b) Blockade of thyrotropin (TSH) secretion in view of the TSH-dependence of DTC (TSH-suppressive therapy). Levothyroxine (L-T4) is the hormone of choice, since combination with levotriiodothyronine does not add any clear advantage with respect to L-T4 monotherapy. While replacement therapy obviously is a lifelong requirement, duration of TSH-suppressive therapy depends on the tumor risk stratification after and the response to the initial treatment. According to recent European and American guidelines, in low-risk DTC LT4 treatment should be carried out at TSH-suppressive doses until there is evidence that the patient is disease-free. In high-risk DTC, TSH suppression should be maintained for several years after such an evidence has been achieved. Afterwards, the patient can be shifted to replacement doses, also to avoid the risks of iatrogenic thyrotoxicosis, especially in the elderly and/or in the presence of cardiovascular disease. The dose of L-T4 must be invidualized; particular attention must be given to the coexistence of pathophysiological conditions or drug treatments that may affect L-T4 absorption or metabolism.
Export Options
About this article
Cite this article as:
Piantanida Eliana, Compri Emanuele, Gandolfo Myriam, Sassi Lorenza, Dionigi Gianlorenzo, Lai Adriana, Tanda Laura Maria and Bartalena Luigi, Thyroid Hormone Treatment for Differentiated Thyroid Carcinoma: What Drug, How Long, What Dose?, Current Cancer Therapy Reviews 2009; 5 (4) . https://dx.doi.org/10.2174/157339409789712717
DOI https://dx.doi.org/10.2174/157339409789712717 |
Print ISSN 1573-3947 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6301 |
Call for Papers in Thematic Issues
Current progress in Protein Degradation and Cancer Therapy
argeted Protein Degradation is gaining momentum in cancer therapy, it facilitate targeting undruggable proteins, it overcome cancer resistance and avoid undesirable side effects. Thus small molecules degraders have emerged as novel therapeutic strategy. Targeted protein degradation (TPD), the process of eliminating a protein of interest hold a great promise for ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
The Use of Ghrelin and Ghrelin Receptor Agonists as a Treatment for Animal Models of Disease: Efficacy and Mechanism
Current Pharmaceutical Design Construction and Analysis of mRNA and lncRNA Regulatory Networks Reveal the Key Genes Associated with Prostate Cancer Related Fatigue During Localized Radiation Therapy
Current Bioinformatics Epigenetic Regulation and Promising Therapies in Colorectal Cancer
Current Molecular Pharmacology Metastatic Thyroid Cancer Unresponsive to Conventional Therapies: Novel Management Approaches Through Translational Clinical Research
Current Drug Targets - Immune, Endocrine & Metabolic Disorders Association of Metronidazole with Cancer: A Potential Risk Factor or Inconsistent Deductions?
Current Drug Metabolism AKT: A Potential Target for Thyroid Cancer Therapy
Current Drug Targets - Immune, Endocrine & Metabolic Disorders Cancer Proteomics: New Horizons and Insights into Therapeutic Applications
Current Proteomics The Emerging Role of EMT-related lncRNAs in Therapy Resistance and their Applications as Biomarkers
Current Medicinal Chemistry Update on Myositis Therapy: From Today’s Standards to Tomorrow’s Possibilities
Current Pharmaceutical Design Targeting Tumor Proteasome with Traditional Chinese Medicine
Current Drug Discovery Technologies Anticipation in Lynch Syndrome: Where We Are Where We Go
Current Genomics Editorial (Thematic Issue: Lutetium-177 Labeled Therapeutics: 177Lu-PSMA is Set to Redefine Prostate Cancer Treatment)
Current Radiopharmaceuticals The Correspondence Between Magnetic Resonance Images and the Clinical and Intraoperative Status of Patients with Spinal Tumors
Current Medical Imaging Biochemical Markers of Renal Function
Current Medicinal Chemistry A Novel Method for Screening of Anti-Cancer Drugs: Availability of Screening in Acidic Medium
Recent Patents on Biomedical Engineering (Discontinued) Anticancer Effects of the Organosilicon Multidrug Resistance Modulator SILA 421
Anti-Cancer Agents in Medicinal Chemistry Advances in the Development of Class I Phosphoinositide 3-Kinase (PI3K) Inhibitors
Current Topics in Medicinal Chemistry Polymeric Carrier Systems for siRNA Delivery
Current Topics in Medicinal Chemistry Hepatitis C Treatment in Patients with Drug Addiction: Clinical Management of Interferon-Alpha-Associated Psychiatric Side Effects
Current Drug Abuse Reviews Role of Unani Medicines in Cancer Control and Management
Current Drug Therapy