Publication: Iodine-131 metaiodobenzylguanidine (131I-mIBG) treatment in relapsed/refractory neuroblastoma
Issued Date
2020-04-01
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14735628
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2-s2.0-85081944277
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Mahidol University
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SCOPUS
Bibliographic Citation
Nuclear medicine communications. Vol.41, No.4 (2020), 336-343
Suggested Citation
Yoch Anongpornjossakul, Wattanun Sriwatcharin, Kanungnij Thamnirat, Wichana Chamroonrat, Arpakorn Kositwattanarerk, Chirawat Utamakul, Chanika Sritara, Payap Chokesuwattanasakul, Nintita Sripaiboonkij Thokanit, Samart Pakakasama, Usanarat Anurathapan, Pongpak Pongphitcha, Chanisa Chotipanich, Suradej Hongeng Iodine-131 metaiodobenzylguanidine (131I-mIBG) treatment in relapsed/refractory neuroblastoma. Nuclear medicine communications. Vol.41, No.4 (2020), 336-343. doi:10.1097/MNM.0000000000001152 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/53717
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Title
Iodine-131 metaiodobenzylguanidine (131I-mIBG) treatment in relapsed/refractory neuroblastoma
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Abstract
BACKGROUND: I-meta-iodo-benzylguanidine (I-mIBG) therapy has been used in treatment of for advanced neuroblastoma for many years with promising results. There are several studies regarding predictors and outcomes of I-mIBG therapies in relapsed/refractory neuroblastoma patients. OBJECTIVE: To identify the predictors and outcomes of I-mIBG treatment in relapsed/refractory neuroblastoma. METHODS: This study was a retrospective review of 22 patients with high risk stage IV relapsed/refractory neuroblastoma who received at least one cycle of I-mIBG therapy. Patient' characteristics, hematologic toxicity, scintigraphic semi-quantitative scoring, and overall survival were recorded. Factors predicting survival were analyzed. RESULTS: Twenty-two patients (50% male) with mean age of 3.7 years (4.8 months to 8.3 years) received I-mIBG therapies at an average of 3.8 and mean dose of 136 mCi (5032 MBq) per treatment. Most common acute hematologic toxicity was thrombocytopenia. Overall 5-year survival rate was 37% (95% confidence interval: 16.3-58.0) and median survival time was 2.8 year (95% confidence interval: 1.38-6.34). Patients with rising Curie score of ≥25% upon the second therapy were major determinants of overall survival with poorer response to treatment. At least three treatments of I-mIBG were needed to identify some degrees of survival prolongation (crude hazard ratio: P-value = 0.003). Age, sex, metastatic status, and baseline Curie scoring system were good predictors associated with survival. Seven patients (32%) demonstrated objective responses. CONCLUSION: Despite multimodality therapy, high risk neuroblastoma had a propensity of treatment failure in terms of relapsed or refractory, with some objective responses after I-mIBG treatments. The declined or non-rising Curie score upon second post-treatment total body scan was an important predictor of survival and aided a decision whether or not to proceed with bone marrow transplantation.