Recombinant human TSH for thyroid remnant ablation with (131)I in children and adolescents with papillary carcinoma.

Background: The objective of this study was to report the results of a series of 12 patients with papillary carcinoma aged 16 years or younger, who were prepared with recombinant human TSH (rhTSH) for remnant ablation with (131)I. The TSH levels achieved and the safety of 24 cycles of rhTSH administration (ablation and control assessment) are reported.

Methods: All patients were prepared using the same protocol as recommended for adults. Eight to 12 months after initial therapy, the patients were submitted to neck ultrasound, measurement of stimulated Tg and anti-Tg antibodies (TgAb), and diagnostic whole-body scanning (DxWBS).

Results: TSH levels >50 mIU/l were achieved in all patients. An adverse reaction (mild nausea and headache) was observed in 1/24 cycles (4.1%). Eight (88.8%) of 9 patients with uptake in the thyroid bed in post-therapy whole-body scanning (RxWBS) achieved complete remission. One patient presented TgAb in the absence of apparent disease. In addition, imaging methods showed no apparent disease in the 2 patients with lymph node metastases in RxWBS. Elevated Tg persisted in 1 patient with pulmonary micrometastases.

Conclusion: The present results demonstrate the efficacy and safety of rhTSH in children and adolescents.