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Quality of life comparison in thyroxine hormone withdrawal versus triiodothyronine supplementation prior to radioiodine ablation in differentiated thyroid carcinoma: a prospective cohort study in the Indian population

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Abstract

Background

Thyroid withdrawal in preparation for radioiodine ablation (RIA) may have a profound impact on health-related quality of life (HRQL). Cost implications and scheduling limit the use of recombinant TSH and triiodothyronine (T3) with its shorter half-life is a conceptually attractive alternative.

Methods

Prospective cohort study design with patients having withdrawal of thyroxine (n = 37) or T3 supplementation (n = 33). HRQL was assessed using EORTC QLQ-C30, QLQ-H&N35 and modified Billewicz questionnaires. Time interval to achieve optimal TSH levels (at least 30 mIU/ml) prior to RIA was determined.

Results

With the exception of emotional domain (QLQ-C30 p = 0.045), LT3 supplementation did not confer significant benefit when compared to LT4 withdrawal. Target serum TSH levels was achieved in 95% of patients by week 4 post thyroidectomy.

Conclusions

LT3 supplementation delivered equivocal benefit and therefore the alternate strategies to minimize the impact on HRQL of reduction in the duration of hypothyroidism in T4 withdrawal are suggested.

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Authors and Affiliations

  1. Department of Surgical Oncoligist, Thangam Hospital, No.54, Dr Sankaran road, Namakkal, Tamil Nadu, India

    Saravana Rajamanickam

  2. Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Parel, Mumbai, 400012, Maharashtra, India

    Devendra Chaukar

  3. University Hospital, Birmingham NHS Foundation Trust, Birmingham, UK

    Somiah Siddiq

  4. Department of Nuclear Medicine, Radiation Medicine Centre, Homi Bhabha National Institute (HBNI), Parel, Mumbai, 400012, Maharashtra, India

    Sandip Basu

  5. Oncology Apollo Group of Hospitals, Plot #13, Parsik Hill Road, Off Uran Road, Sector - 23, CBD Belapur, Opp. Nerul Wonders Park, Navi Mumbai, Maharashtra, India

    Anil D’Cruz

Authors
  1. Saravana Rajamanickam
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  2. Devendra Chaukar
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  4. Sandip Basu
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  5. Anil D’Cruz
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Contributions

Study concepts: SR, DC, AD, SB. Study design: SR, DC, AD, SB. Data acquisition: SR, SS. Quality control of data and algorithms: SR, DC. Statistical analysis: SR, SS. Manuscript preparation: all authors. Manuscript editing: all authors. Manuscript reviewing: all authors.

Corresponding author

Correspondence to Devendra Chaukar.

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Conflict of interest

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Ethical approval

The study was conducted in adherence to the existing ethical standards. The authors confirm strict adherence to the ethical standards. All received the standard of care for their condition and was as per the ethical standards. No patient contact was made. Approval from our institute Ethics Committee was obtained.

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No identifying information about participants is available in the article. However, all patients have given consent for the treatment they have received.

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Rajamanickam, S., Chaukar, D., Siddiq, S. et al. Quality of life comparison in thyroxine hormone withdrawal versus triiodothyronine supplementation prior to radioiodine ablation in differentiated thyroid carcinoma: a prospective cohort study in the Indian population. Eur Arch Otorhinolaryngol 279, 2011–2018 (2022). https://doi.org/10.1007/s00405-021-06948-6

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  • DOI: https://doi.org/10.1007/s00405-021-06948-6

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