Allan Hackshaw, Deputy Director of Cancer Research UK, comments:
“Recommended treatment for most patients with differentiated thyroid cancer is surgery followed by a high administered dose of 3.7 GBq (100mCi) radioiodine ablation. However, a lower dose (1.1 GBq or 30 mCi) has advantages including a shorter stay in hospital isolation and lower risk of side effects, including the risk of a second cancer.
“Also, Thyrogen allows patients to continue thyroid hormone replacement during ablation, avoiding symptoms of hypothyroidism, but there was uncertainty over whether this could affect ablation success rates.
“HiLo was a large randomised trial to simultaneously address whether ablation success rates are similar using (i) either 1.1 GBq or 3.7 GBq, and (ii) either Thyrogen or thyroid hormone withdrawal. It was the first ever UK national prospective trial in thyroid cancer.
“Four hundred and thirty eight patients were recruited from 31 UK centres between January 2007 and April 2010. The trial showed that 1.1 GBq could be used instead of 3.7 GBq. Also, ablation success rates were not affected if patients had Thyrogen.
“There were fewer side effects with 1.1 GBq, and the quality of life and other hypothyroid symptoms before ablation were much better among patients who had Thyrogen (compared to those who had hormone withdrawal).
” The HiLo research team now recommend the use of 1.1 GBq with Thyrogen in routine practice.”
Professor Allan Hackshaw, Deputy Director
Cancer Research UK & UCL Cancer Trials Centre
University College London
5th floor, 90 Tottenham Court Road