Abstract
This study aimed to compare “non-treated” versus
“levotriiodothyronine (LT3)-treated” protocols of short-term
hypothyroidism induction prior to radioactive iodine (RAI) ablation therapy in
differentiated thyroid cancer (DTC). A total of 120 DTC patients who had
thyroxine withdrawal either via 4-week hypothyroidism induction (non-treated
group, n=60) or 2-week administration and then 2-week withdrawal of LT3
(LT3-treated group, n=60) to induce hypothyroid state prior to RAI
ablation after initial surgery were included. Complications related to
hypothyroidism-induction, Beck Depression Inventory (BDI), Hospital
Anxiety-Depression Scale (HADS), and SF-36 health-related quality of life
(HRQoL) scores were recorded. In the non-treated group, transition from
euthyroid to hypothyroid state was associated with significant increase in the
likelihood of moderate-to-severe depression on BDI (p<0.001), presence
of depression on HADS-D (p<0.001), presence of anxiety on HADS-A
(6.7% during euthyroid state vs. 33.3% during hypothyroid state,
p<0.001), and major syndrome on BPRS (0.0 vs. 10.0%,
p=0.001) as well as significant decrease in all SF-36 HRQoL domain
scores (p<0.001 for each). In conclusion, our findings indicate the
likelihood of L3-treatment to enable a more favorable transition period from
euthyroid to hypothyroid state without experiencing a deterioration in
depression, anxiety, or HRQoL.
Key words differentiated thyroid carcinoma - hypothyroidism induction - LT3- protocol - depression - anxiety - quality of life
