The efficacy of I-131 metaiodobenzylguanidine (MIBG) treatment in previously heavily treated stage IV neuroblastoma patients (age more than 1 year): Preliminary experiences

Abstract

20025 Background: The outcome of advanced stage neuroblastoma patients with multiple relapsed or refractory diseases is very dismal. We therefore would like to study the efficacy and the safety of I-131 MIBG treatment in this group of patients. Method: A retrospective study of six stage IV neuroblastoma patients (pts) (2 males and 4 females), age at the diagnosis range 3 to 8 years from January 2005 to December 2006 were studied. All pts were previously treated with multiple regimens of chemotherapy, high-dose chemotherapy with autologous peripheral stem cells (PBSCs) rescue, salvage surgery, and local radiation ( table ). All these patients had relapsed or refractory disease at the time of I-131 MIBG treatment. The therapeutic dose of I-131 MIBG activity per course was given on the basis of weight, the hematological parameter, and tumor response assessment. The cycle of treatment was more 4 weeks apart. The treatment response was evaluated by imaging. and neuron-specific enolase (NSE) levels. Results: A total of 21 courses of I-131 MIBG were administered: one patient received one course, two received three courses, two received four courses and one received six courses. The median therapeutic dose of I-131 MIBG was 5.5 GBq (range; 1.1–5.5). Median duration of response was 10 months (range, 1–19). A partial response achieved in 1, and stable response in 5 patients. Pain relief was observed in 1/1 patients with bone pain. The most common side effect found was thrombocytopenia which became more severe with increasing number of course, grade 2 thrombocytopenia occurring in 4/6 patients over 3 courses of therapy. Three children died whereas three are still alive. There is no morbidity from the therapy. Conclusion: It can be concluded that MIBG treatment is effective and less toxic in patients with relapsed or refractory neuroblastoma and further studies of the role of I-131 MIBG treatment in advanced neuroblastoma in Thailand are needed. [Table: see text] No significant financial relationships to disclose.