[Targeted radionuclide therapy for patients with metastatic medullary thyroid carcinoma].
OBJECTIVE
To evaluate the effect of 90Y-DOTATOC and 131I-MIBG in treatment of metastatic medullary thyroid carcinoma (MTC).


METHODS
Twelve histologically confirmed patients with metastatic MTC were included. All patients underwent both 111In-DTPA-octreotide imaging and 131I/ 123I-meta-iodobenzylguanidine (MIBG) imaging. According to the results of the combined imaging, positive patients were selected to be treated with 90Y-DOTA-D-Phe1-Tyr3-octreotide (90Y-DOTATOC) or 131I-MIBG, respectively. The therapeutic procedures of targeted internal radiation were performed with 3.33 GBq 90Y-DOTATOC at 6-week intervals, or 11.1 GBq 131I-MIBG with a minimum interval of three months.


RESULTS
The imaging procedure was positive in all 12 patients: 111In-DTPA-octreotide imaging in eight patients, 131I/ 123I-MIBG imaging in six patients. According to the results of combined imaging, we identified four patients to be treated with 90Y-DOTATOC, and five patients with 131 I-MIBG. After three to five sessions of treatment, three patients with partial remission and six with stable disease were observed. The effective rate was 3/9 (33.3%) and the overall tumor response rate was 9/9 (100%). No relevant toxicity was observed.


CONCLUSIONS
The combined imaging technique can be used to identify patients for effective radionuclide treatment. The treatment with 90Y-DOTATOC or 131I-MIBG is well tolerated and may improve the fate of patients with metastatic MTC.
Gao
Zai-rong
ZR
Department of Nuclear Medicine, Union Hospital, Tongii Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. gaobonn@yahoo.com.cn
An
Rui
R
Zhang
Yong-xue
YX
Biersack
Hans J
HJ
D019797:3-Iodobenzylguanidine / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018276:Carcinoma, Medullary / Q000378:metabolism / Q000532:radiotherapy* / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004369:Pentetic Acid / Q000031:analogs & derivatives; D049268:Positron-Emission Tomography; D012074:Remission Induction; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology / Q000528:radiation effects; D013963:Thyroid Hormones / Q000378:metabolism; D013964:Thyroid Neoplasms / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
C497824:111In-octreotide, DTPA(0)-; D000970:Antineoplastic Agents; D007205:Indium Radioisotopes; D013963:Thyroid Hormones; D015021:Yttrium Radioisotopes; D019797:3-Iodobenzylguanidine; D004369:Pentetic Acid; C496730:90Y-octreotide, DOTA-Tyr(3)-; D015282:Octreotide