The treatment of neuroblastoma with [131I]MIBG at diagnosis.
The potential role [131I]MIBG therapy in untreated, inoperable cases of neuroblastoma (NB) in children was evaluated. Six children, aged 10 months-5 years, were treated at diagnosis. Five (4 stage III and 1 stage IV NB) underwent [131I]MIBG treatment alone (single doses ranging from 2.9 to 6.1 GBq of high specific activity [131I]MIBG. In one case (stage IV NB) [131I]MIBG was preceded by Cisplatin administration (20 mg/m2/day) given over a 5 day period. The results obtained in the first 5 cases were as follows: 1 complete response still lasting after 5 years; 1 partial and 1 minor response allowing further surgery and chemotherapy; 2 stabilization of the disease. The treatment was well tolerated with minimal toxicity. However, apart from the first case all these children relapsed and subsequently died. Therefore [131I]MIBG therapy (9.1 GBq given in 2 courses) combined with Cisplatin as a "radiosensitizer" was used in the sixth case, a patient with widespread bone metastases and massive bone marrow involvement. A very good partial response was obtained in this case. Further surgery (of the primary NB) and multidrug chemotherapy was then possible. In conclusion, [131I]MIBG therapy at diagnosis appears to be effective, low toxic treatment of NB; when integrated with Cisplatin its efficacy seems to improve even more.
Troncone
L
L
Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy.
Rufini
V
V
Luzi
S
S
Mastrangelo
R
R
Riccardi
R
R
D019797:3-Iodobenzylguanidine; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019046:Bone Marrow Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary; D001859:Bone Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary; D002675:Child, Preschool; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D007457:Iodine Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use*; D007462:Iodobenzenes / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000627:therapeutic use*; D012074:Remission Induction; D015996:Survival Rate
D000970:Antineoplastic Agents; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D011838:Radiation-Sensitizing Agents; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D002945:Cisplatin