Assessment of the efficacy and toxicity of (131)I-metaiodobenzylguanidine therapy for metastatic neuroendocrine tumours.
(131)I-metaiodobenzylguanidine ((131)I-MIBG) is a licensed palliative treatment for patients with metastatic neuroendocrine tumours. We have retrospectively assessed the consequences of (131)I-MIBG therapy in 48 patients (30 gastroenteropancreatic, 6 pulmonary, 12 unknown primary site) with metastatic neuroendocrine tumours attending Royal Liverpool University Hospital between 1996 and 2006. Mean age at diagnosis was 57.6 years (range 34-81). (131)I-MIBG was administered on 88 occasions (mean 1.8 treatments, range 1-4). Twenty-nine patients had biochemical markers measured before and after (131)I-MIBG, of whom 11 (36.7%) showed >50% reduction in levels post-therapy. Forty patients had radiological investigations performed after (131)I-MIBG, of whom 11(27.5%) showed reduction in tumour size post-therapy. Twenty-seven (56.3%) patients reported improved symptoms after (131)I-MIBG therapy. Kaplan-Meier analysis showed significantly increased survival (P=0.01) from the date of first (131)I-MIBG in patients who reported symptomatic benefit from therapy. Patients with biochemical and radiological responses did not show any statistically significant alteration in survival compared to non-responders. Eleven (22.9%) patients required hospitalisation as a consequence of complications, mostly due to mild bone marrow suppression. (131)I-MIBG therefore improved symptoms in more than half of the patients with metastatic neuroendocrine tumours and survival was increased in those patients who reported a symptomatic response to therapy.
Nwosu
A C
AC
Division of Gastroenterology, University of Liverpool, Liverpool, UK.
Jones
L
L
Vora
J
J
Poston
G J
GJ
Vinjamuri
S
S
Pritchard
D M
DM
D019797:3-Iodobenzylguanidine / Q000009:adverse effects* / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006402:Hematologic Diseases / Q000209:etiology; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine