內科專科醫生題庫下載題庫

(D)正確，應保持低TSH level

 Because most tumors are still TSH-responsive, levothyroxine suppression of TSH is a mainstay of thyroid cancer treatment. Although TSH suppression clearly provides therapeutic benefit, there are no prospective studies that define the optimal level of TSH suppression. The degree of TSH suppression should be individualized based on a patient’s risk of recurrence. It should be adjusted over time as surveillance blood tests and imaging confirm absence of disease or, alternatively, indicate possible residual/recurrent cancer. For patients at low risk of recurrence, TSH should be maintained in the lower normal limit (0.5–2.0 mIU/L). For patients either at inter- mediate or high risk of recurrence, TSH levels should be kept to 0.1 to 0.5 mIU/L and <0.1 mIU/L, respectively, if there are no strong contraindications to mild thyrotoxicosis. TSH should be <0.1 mIU/L for those with known metastatic disease.