title: Iodine -131 metaiodobenzylguanidine is an effective treatment for malignant pheochromocytoma and paraganglioma.
abstract: BACKGROUND
  Iodine 131-meta-iodobenzylguanidine ((131)I-MIBG) has been applied to the palliative treatment of metastatic pheochromocytoma in small studies. We report our institutional experience for the treatment of metastatic pheochromocytoma and paraganglioma.
  
  
  METHODS
  We performed a retrospective review of 33 patients with metastatic pheochromocytoma (n=22) and paraganglioma (n=11) treated at our institution with (131)I-MIBG over a 10-year period.
  
  
  RESULTS
  Patients received a mean dose of 388+/-131 mCi (131)I-MIBG. Median survival after treatment was 4.7 years. Most patients experienced a symptomatic response leading to an improved survival (4.7 years vs 1.8 years, P<.01). Patients with a measurable hormone response demonstrated an increased survival in comparison to those with no response (4.7 years vs 2.6 years, P=.01). Patients who received a high dose (>500 mCi) as their initial therapy also had improved survival (3.8 years vs 2.8 years, P=.02).
  
  
  CONCLUSIONS
  These data support (131)I-MIBG treatment for select patients with metastatic pheochromocytoma. In our experience, prolonged survival was best predicted by symptomatic and hormone response to (131)I-MIBG treatment. An initial dose of 500 mCi may be optimal. The benefit of (131)I-MIBG treatment for metastatic pheochromocytoma must also be weighed against its side effects.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: Safford
authors.forename: R Edward
authors.initials: RE
authors.lastname: Coleman
authors.forename: Jon P
authors.initials: JP
authors.lastname: Gockerman
authors.forename: Joseph
authors.initials: J
authors.lastname: Moore
authors.forename: Jerome M
authors.initials: JM
authors.lastname: Feldman
authors.forename: George S
authors.initials: GS
authors.lastname: Leight
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Tyler
authors.forename: John A
authors.initials: JA
authors.lastname: Olson
mesh_terms: D019797:3-Iodobenzylguanidine / Q000627:therapeutic use*; D000310:Adrenal Gland Neoplasms / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000532:radiotherapy*; D010673:Pheochromocytoma / Q000532:radiotherapy*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine