Thyroid Cancer Clinical Trial
Official title:
Medico-Economic Comparison of Four Strategies of Radioiodine Ablation in Thyroid Carcinoma Patients - Estimabl
In France, 3,700 new cases of thyroid cancer are diagnosed each year. Differentiated thyroid
carcinoma represents more than 90% of all thyroid cancers; and has a 10-year survival of
90-95% of patients. This favorable prognosis is the result of an effective primary therapy,
which consists of a total thyroidectomy that is followed by radio-iodine ablation with
3,7GBq (100mCi) in case of significant risk of persistent disease. Few centers investigated
the possibility to administer lower doses of 131I (1GBq, 30 mCi), in order to limit the
potential long-term adverse complications for patients and to respond to radioprotection
rules for family members and medical staff.
Radio-iodine ablation requires TSH stimulation, which was historically achieved by thyroid
hormone withdrawal for 3 to 5 weeks. During this period, patients suffered from symptoms of
hypothyroidism. The recombinant human TSH (rhTSH, Thyrogen®, Genzyme Therapeutics,
Cambridge, USA) was approved in Europe in 2005 as an alternative stimulation procedure to
withdrawal during ablation. It allows patients to remain euthyroid on thyroid hormone
therapy (that needs not to be withdrawn). However, this a costly drug (800 € per patient),
whose economic efficiency needs to be checked.
This is a multicentric, randomized, controlled, open-label phase III clinical trial involving 26 French centers. It aims at comparing four strategies of management of postoperative radioiodine ablation, each strategy combining a method of TSH stimulation (thyroid hormone withdrawal or rhTSH (Thyrogen®, Genzyme)) and an activity of 131I (low-dose (1GBq, 30 mCi) or high-dose (3,7GBq, 100 mCi)). ;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Treatment
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