title: Second malignancies in children with neuroblastoma after combined treatment with 131I-metaiodobenzylguanidine.
abstract: BACKGROUND
  (131)I-metaiodobenzylguanidine ((131)I-MIBG) is selectively taken up by cells of neural crest origin, allowing targeted radiotherapy of tumors such as neuroblastoma (NB) and pheochromocytoma. Radiotherapy may provide additional benefits in the treatment of NB, with moderate side effects such as hematologic and thyroid toxicity. However, with longer follow-up, other complications might occur. We describe our experience with second cancers occurring in children treated with (131)I-MIBG and chemotherapy.
  
  
  METHODS
  The clinical records of 119 consecutive NB cases treated with (131)I-MIBG at a single institution between 1984 and 2001 were reviewed for the occurrence of a second malignant neoplasm (SMN).
  
  
  RESULTS
  Overall, five cases of SMN occurred in the study patients. In particular, two cases of myeloid leukemia, one of angiomatous fibrous histiocytoma, one of malignant schwannoma, and one case of rhabdomyosarcoma were detected. The schwannoma and the rhabdomyosarcoma developed within the residual neuroblastic mass after first-line therapy.
  
  
  CONCLUSIONS
  Should (131)I-MIBG treatment become more broadly employed in the therapeutic strategy for neuroblastoma, the risk of second cancer will have to be taken into consideration. The organization of an international registry of subjects treated with (131)I-MIBG might better define the frequency and features of second malignancies following this radiometabolic approach.
authors.affiliation: Department of Pediatric Hematology/Oncology, G. Gaslini Children's Hospital, Genova, Italy. albertogaraventa@ospedale-gaslini.ge.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Garaventa
authors.forename: Claudio
authors.initials: C
authors.lastname: Gambini
authors.forename: Giampiero
authors.initials: G
authors.lastname: Villavecchia
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Cataldo
authors.forename: Luigi
authors.initials: L
authors.lastname: Bertolazzi
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Pizzitola
authors.forename: Bruno
authors.initials: B
authors.lastname: De Bernardi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Haupt
mesh_terms: D019797:3-Iodobenzylguanidine / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology; D007223:Infant; D008297:Male; D009381:Neoplasms, Radiation-Induced; D016609:Neoplasms, Second Primary; D009447:Neuroblastoma / Q000188:drug therapy / Q000532:radiotherapy*; D010524:Peripheral Nervous System Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine