Fast-track Radioiodine Ablation Therapy After Thyroidectomy Reduces Sick Leave in Patients With Differentiated Thyroid Cancer (FASTHYNA Trial)

Farahnaz Waissi, Jakob W Kist, Lutske Lodewijk, Ardine G de Wit, Jos A van der Hage, Thijs van Dalen, Bart de Keizer, Gerlof D Valk, Inne H M Borel Rinkes, Menno R Vriens

Research output: Contribution to journalArticleAcademicpeer-review


Background: Recombinant human thyroid stimulating hormone (RhTSH) aided radioiodine ablative therapy (RIT) is current-day practice in the treatment of differentiated thyroid cancer (DTC). It is often planned 4 to 6 weeks after surgery or sometimes even longer (standard protocol). The RhTSH-aided RIT, however, has the advantage that it can be planned shortly after thyroidectomy. The FASTHYNA trial was designed to test the hypothesis that RIT 1 week after thyroidectomy (fast-track protocol) results in a significant reduction of sick leave with lower societal costs and with a better quality of life (QOL) compared with the current standard treatment. Methods: In a randomized, multicenter trial, we included patients with differentiated thyroid cancer, stage T1-3 N0-1 M0-x, who were treated with a total or completion thyroidectomy, with a paid job of at least 12 hours per week. The primary study end point was days of sick leave reported from time of surgery. Secondary end points were QOL and societal costs associated with absence from work. Results: Twenty patients were eligible for inclusion between November 2013 and May 2016. Significant decreases in mean duration of sick leave in the fast-track group versus the standard care group (115 and 280 hours, respectively, P = 0.02) and in costs associated with productivity losses (€4070.77 vs €9202.90, P = 0.02) were found. There were no significant differences in QOL between both groups. Conclusions: The trial showed a significant reduction in sick leave and in societal costs in the fast-track group without a deterioration of QOL. Therefore, fast-track ablation is desirable. Trial Registration: Netherlands trial register: NTR 3933.

Original languageEnglish
Pages (from-to)272-275
Number of pages4
JournalClinical Nuclear Medicine
Issue number4
Early online date17 Dec 2018
Publication statusPublished - Apr 2019


  • fast-track
  • quality of life
  • radioactive iodine ablation
  • recombinant human TSH
  • thyroid cancer
  • Thyroid Neoplasms/pathology
  • Humans
  • Middle Aged
  • Male
  • Sick Leave/statistics & numerical data
  • Thyroidectomy
  • Iodine Radioisotopes/therapeutic use
  • Time Factors
  • Quality of Life
  • Adult
  • Female


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