Early Side Effects of rhTSH-Aided Radioiodine Ablation and Treatment of Differentiated Thyroid Cancer: A Real-World Experience

We aimed to investigate the early side effects of recombinant human thyroid-stimulating hormone (rhTSH)-aided radioactive iodine (RAI) administration in an unselected cohort of patients with differentiated thyroid cancer (DTC) in the real-world setting. During follow-up (at 6 weeks, 6 months, and 12 months post-RAI) of patients with DTC who received rhTSH-aided RAI, we used a standardized questionnaire to collect patient-reported side effects of RAI. We investigated the factors that impact the occurrence of RAI-associated side effects. A total of 111 patients with a female predominance (66.7%) and a mean age of 51.1 ± 16.0 years were included, including 13 patients (11.7%) who had previously received RAI. The predominant tumor histology was papillary thyroid cancer, with 91.0% of patients having stage I/II disease. At 6-week follow-up, loss of taste/smell, nausea, salivary gland pain or swelling, dry mouth, and neck pain were reported by 45.9, 37.8, 30.6, 36.9, and 20.7% of patients, respectively. In most patients, these side effects lasted for less than 1 week. At 6-month post-RAI, 13 patients reported lingering RAI-associated side effects, including 4 and 3 patients who reported dry mouth and dry eyes, respectively. A 12-month post-RAI, one patient each reported dry eyes, watery eyes, and fatigue as RAI side effects. Women were at higher risk of neck pain, while young patients were more likely to experience nausea (p < 0.05). rhTSH-aided RAI administration in DTC patients is associated with tolerable side effects, most of which resolved within weeks of treatment.