Evidence map›Paper›PMID 22551128›Full record

Trial reportThe New England journal of medicine2012

Ablation with low-dose radioiodine and thyrotropin alfa in thyroid cancer.

Ujjal Mallick, Clive Harmer, Beng Yap, Jonathan Wadsley, Susan Clarke, Laura Moss, Alice Nicol, Penelope M Clark, Kate Farnell, Ralph McCready and 18 more

2 registry-linked trialsOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 188 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
188citing papers in PubMed, 13 pooled it
38.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00415233 phase3unknown statusnot on this map

Multicentre Randomised Trial of High Dose Versus Low Dose Radioiodine, With or Without Recombinant Human Thyroid Stimulating Hormone, for Remnant Ablation Following Surgery for Differentiated Thyroid Cancer [HILO]

TypeinterventionalSponsorUniversity College, LondonRan2006 to 2025Enrolled438ConditionsHead and Neck CancerArmsrecombinant thyroid-stimulating hormone, Radiodine ablation without rhTSH
NCT04354324 naunknown statusnot on this mapstarted 2020, after this paper: background citation

Treatment Efficacy and Safety of Low-dose Radioiodine Ablation for Intermediate-risk Differentiated Thyroid Carcinoma Patients Without Metastasis: a Double-blind Randomized Clinical Trial

TypeinterventionalSponsorZhujiang HospitalRan2020 to 2024Enrolled254ConditionsPapillary Thyroid CancerArmsRadioiodine
3 · Its place in the literature

Who cites it

188 citing papers in PubMed, 13 syntheses or guidelines pooled it, 610 citations in OpenAlex.

  1. Guideline
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Guideline
  6. Pooled it
  7. Differentiated Thyroid Cancer-Treatment: State of the Art.International journal of molecular sciences · 2017
    Pooled it
  8. I-131 for Remnant Ablation in Differentiated Thyroid Cancer After Thyroidectomy: A Meta-Analysis of Randomized Controlled Evidence.Medical science monitor : international medical journal of experimental and clinical research · 2016
    Pooled it
  9. Pooled it
  10. Guideline
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. RhTSH in aiding dynamic assessment in patients with differentiated thyroid Cancer.European journal of nuclear medicine and molecular imaging · 2025
    Trial
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Article
  20. Comparison betweenQuantitative imaging in medicine and surgery · 2026
    Article

128 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

28 authors at 1 institution in 1 country.

Ujjal MallickNorthern Centre for Cancer Care, Freeman Hospital, Level 4, Freeman Rd., Newcastle upon Tyne, NE7 7DN United Kingdom. ujjal.mallick@nuth.nhs.uk
Clive Harmer
Beng Yap
Jonathan Wadsley
Susan Clarke
Laura Moss
Alice Nicol
Penelope M Clark
Kate Farnell
Ralph McCready
James Smellie
Jayne A Franklyn
Rhys John
Christopher M Nutting
Kate Newbold
Catherine Lemon
Georgina Gerrard
Abdel Abdel-Hamid
John Hardman
Elena Macias
Tom Roques
Stephen Whitaker
Rengarajan Vijayan
Pablo Alvarez
Sandy Beare
Sharon Forsyth
Latha Kadalayil
Allan Hackshaw
Freeman Hospital · GB

Funding

Cancer Research UK C18243/A5802
6 · The paper itself

Abstract

backgroundIt is not known whether low-dose radioiodine (1.1 GBq [30 mCi]) is as effective as high-dose radioiodine (3.7 GBq [100 mCi]) for treating patients with differentiated thyroid cancer or whether the effects of radioiodine (especially at a low dose) are influenced by using either recombinant human thyrotropin (thyrotropin alfa) or thyroid hormone withdrawal.

methodsAt 29 centers in the United Kingdom, we conducted a randomized noninferiority trial comparing low-dose and high-dose radioiodine, each in combination with either thyrotropin alfa or thyroid hormone withdrawal before ablation. Patients (age range, 16 to 80 years) had tumor stage T1 to T3, with possible spread to nearby lymph nodes but without metastasis. End points were the rate of success of ablation at 6 to 9 months, adverse events, quality of life, and length of hospital stay.

resultsA total of 438 patients underwent randomization; data could be analyzed for 421. Ablation success rates were 85.0% in the group receiving low-dose radioiodine versus 88.9% in the group receiving the high dose and 87.1% in the thyrotropin alfa group versus 86.7% in the group undergoing thyroid hormone withdrawal. All 95% confidence intervals for the differences were within ±10 percentage points, indicating noninferiority. Similar results were found for low-dose radioiodine plus thyrotropin alfa (84.3%) versus high-dose radioiodine plus thyroid hormone withdrawal (87.6%) or high-dose radioiodine plus thyrotropin alfa (90.2%). More patients in the high-dose group than in the low-dose group were hospitalized for at least 3 days (36.3% vs. 13.0%, P<0.001). The proportions of patients with adverse events were 21% in the low-dose group versus 33% in the high-dose group (P=0.007) and 23% in the thyrotropin alfa group versus 30% in the group undergoing thyroid hormone withdrawal (P=0.11).

conclusionsLow-dose radioiodine plus thyrotropin alfa was as effective as high-dose radioiodine, with a lower rate of adverse events. (Funded by Cancer Research UK; ClinicalTrials.gov number, NCT00415233.).

Indexed as

Ablation TechniquesAdolescentAdultAgedAged, 80 and overCombined Modality TherapyFemaleFollow-Up StudiesHumansHypothyroidismIodine RadioisotopesLength of StayMaleMiddle AgedQuality of LifeRadiotherapy DosageIodine RadioisotopesThyroid HormonesThyrotropin Alfa

Identifiers

PMID22551128
OpenAlexW2107717011

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.