Shortened treatment strategy in patients with differentiated thyroid cancer.

The initial treatment of patients with differentiated thyroid cancer (DTC) consists of total thyroidectomy followed by thyroid remnant radioiodine ablative therapy (RIT). For successful RIT, elevated levels of thyroid stimulating hormone (TSH) are required. Before the introduction of recombinant human TSH (rhTSH) patients were withheld thyroid hormone substitution therapy for 4 weeks after surgery. Nowadays RIT after rhTSH admission is possible, preventing thyroid hormone withdrawal and subsequent symptoms of hypothyroidism in these patients. Results of RIT after thyroid hormone withdrawal and rhTSH stimulation are comparable. RIT with rhTSH stimulation allows planning of the RIT shortly after thyroidectomy.



We hypothesize that with the availability of rhTSH the treatment of DTC patients in a fast track protocol, i.e. RIT shortly after thyroidectomy, will reduce sick leave time, which will lead to a cost reduction for society, and secondly that the fast track treatment will lead to a higher quality of life for the patients during treatment. Patients will be sooner ‘back on track’. In this way both society and patients will benefit from the implementation of the fast track protocol.

By reducing the interval between thyroidectomy and radioiodine ablation therapy in patients sick leave time of the patients can be reduced and the quality of life improved. Furhermore costs will for society will be lower.

Continuous monitoring of sick leave and quality of life from start of treatment until 2 months after therapy.

Standard treatment: Thyroidectomy followed by a 4-6 week during waiting period and then ablation with radioactive iodine.



Interventional treatment: Thyroidectomy directly followed by radioactive iodine ablation.