title: The role of 131I-metaiodobenzylguanidine (MIBG) therapy in unresectable and compromising localised neuroblastoma.
abstract: OBJECTIVE
  In patients with localised neuroblastoma without adverse genetic aberrations, observational treatment is justified. Therapy is required when organ or respiratory functions have become compromised. As the outcome is good, side effects of treatment should be prevented. The aim of this retrospective study was to evaluate response and outcome in patients treated with (131)I-metaiodobenzylguanidine (MIBG) for unresectable localised neuroblastoma, with compromised organ functions.
  
  
  METHODS
  Patients with localised neuroblastoma [median age 1.6 years (0-5.5 years)] diagnosed between 1989 and 2008 were included in this retrospective study (n = 21). Primary tumours were unresectable and there was a compromised organ or respiratory function. Diagnosis and staging were performed according to the International Neuroblastoma Staging System. Fixed doses of (131)I-MIBG therapy (50-200 mCi) were given. The median number of infusions was two (range one to seven). Response was graded according to the International Neuroblastoma Response Criteria.
  
  
  RESULTS
  Of the 21 patients, 14 did not need any chemotherapy. Patients were treated with (131)I-MIBG therapy and, in most cases, with additional surgery and/or chemotherapy. Sixteen achieved complete response (CR), three very good partial response (VGPR), one partial response (PR) and one progressive disease (PD). Two patients died of PD after having achieved CR initially and due to surgical complications a few months after resection. Ten-year overall survival and event-free survival were 90.5 %. The median follow-up was 8.5 years (range 0.4-19.6 years).
  
  
  CONCLUSIONS
  (131)I-MIBG therapy is an effective treatment modality for unresectable localised neuroblastoma with compromised organ functions. However, this was a small and heterogeneous cohort and further studies are needed.
authors.affiliation: Department of Paediatric Oncology, Emma Children's Hospital, Academic Medical Centre (AMC), PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
authors.forename: Reineke A
authors.initials: RA
authors.lastname: Schoot
authors.forename: Gitta
authors.initials: G
authors.lastname: Bleeker
authors.forename: Huib N
authors.initials: HN
authors.lastname: Caron
authors.forename: Berthe L
authors.initials: BL
authors.lastname: van Eck
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Heij
authors.forename: Jan
authors.initials: J
authors.lastname: de Kraker
authors.forename: Godelieve A
authors.initials: GA
authors.lastname: Tytgat
mesh_terms: D019797:3-Iodobenzylguanidine / Q000627:therapeutic use*; D000008:Abdominal Neoplasms / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009447:Neuroblastoma / Q000532:radiotherapy*; D010386:Pelvic Neoplasms / Q000532:radiotherapy*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine