title: Repeated Radionuclide therapy in metastatic paraganglioma leading to the highest reported cumulative activity of 131I-MIBG.
abstract: 131I-MIBG therapy for neuroendocrine tumours may be dose limited. The common range of applied cumulative activities is 10-40 GBq. We report the uneventful cumulative administration of 111 GBq (= 3 Ci) 131I-MIBG in a patient with metastatic paraganglioma. Ten courses of 131I-MIBG therapy were given within six years, accomplishing symptomatic, hormonal and tumour responses with no serious adverse effects. Chemotherapy with cisplatin/vinblastine/dacarbazine was the final treatment modality with temporary control of disease, but eventually the patient died of progression. The observed cumulative activity of 131I-MIBG represents the highest value reported to our knowledge, and even though 12.6 GBq of 90Y-DOTATOC were added intermediately, no associated relevant bone marrow, hepatic or other toxicity were observed. In an individual attempt to palliate metastatic disease high cumulative activity alone should not preclude the patient from repeat treatment.
authors.affiliation: Department of Nuclear Medicine, University Hospital, Bonn, Germany. samer.ezziddin@ukb.uni-bonn.de
authors.forename: Samer
authors.initials: S
authors.lastname: Ezziddin
authors.forename: Amir
authors.initials: A
authors.lastname: Sabet
authors.forename: Yon-Dschun
authors.initials: YD
authors.lastname: Ko
authors.forename: Sunny
authors.initials: S
authors.lastname: Xun
authors.forename: Alexander
authors.initials: A
authors.lastname: Matthies
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Biersack
mesh_terms: D019797:3-Iodobenzylguanidine / Q000627:therapeutic use*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D010235:Paraganglioma / Q000532:radiotherapy* / Q000556:secondary; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine