Recurrence after low-dose radioiodine ablation and recombinant human thyroid-stimulating hormone for differentiated thyroid cancer (HiLo): long-term results of an open-label, non-inferiority randomised controlled trial

Publication date: Available online 27 November 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Hakim-Moulay Dehbi, Ujjal Mallick, Jonathan Wadsley, Kate Newbold, Clive Harmer, Allan HackshawSummaryBackgroundTwo large randomised trials of patients with well-differentiated thyroid cancer reported in 2012 (HiLo and ESTIMABL1) found similar post-ablation success rates at 6–9 months between a low administered radioactive iodine (131I) dose (1·1 GBq) and the standard high dose (3·7 GBq). However, recurrence rates following radioactive iodine ablation have previously only been reported in observational studies, and recently in ESTIMABL1. We aimed to compare recurrence rates between radioactive iodine doses in HiLo.MethodsHiLo was a non-inferiority, parallel, open-label, randomised controlled factorial trial done at 29 centres in the UK. Eligible patients were aged 16–80 years with histological confirmation of differentiated thyroid cancer requiring radioactive iodine ablation (performance status 0–2, tumour stage T1–T3 with the possibility of lymph-node involvement but no distant metastasis and no microscopic residual disease, and one-stage or two-stage total thyroidectomy). Patients were randomly assigned (1:1:1:1) to 1·1 GBq or 3·7 GBq ablation, each prepared with either recombinant human thyroid-stimulating hormone (rhTSH) or thyroid hormone withdrawal. Patients were followed up at annual clinic visits. Recurrences were diagnosed at each hospital with a ...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research