Treatment of advanced neuroblastoma with i-131 meta-iodobenzylguanidine

✍ Scribed by Alberto Garaventa; Dr. Bruno De Bernardi; Edoardo Lanino; Paolo Guerra; Mario Bestagno; Luigi Bertolazzi; Gian Paolo Villavecchia; Franco Claudiani; Alberto Arrighini

• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 635 KB
• Volume: 67
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19910215)67:4<922::aid-cncr2820670411>3.0.co;2-d

✦ Synopsis

31 children with advanced pretreated neuroblastoma were treated with 131-1 meta-Iodobenzylguanidine (131-MIBG).

Thirteen children had been resistant to first-line therapy, three had suffered a local relapse, and fourteen had suffered a disseminated relapse without overt bone marrow infiltration. One child was treated initially because of resistance to firstline therapy, and subsequently for a local relapse. A total of 72 courses of 131-MIBG was administered, with doses ranging from 2.8 to 6.0 GBq (median, 3.7 GBq). One child received five courses, two four courses, 13 three courses, four two courses, and 12 one course of 131-MIBG. The most common toxic effect was thrombocytopenia, with a platelet level of less than 50,000/cmm occurring after 19 of 60 evaluable courses. A leukocyte count less than 1000/cmm was seen only once. There were six major responses (two complete) lasting 4 to 9 months, and two minor responses lasting longer than 38 and 44 months. Responses were seen more commonly in children whose only lesion was a residual primary tumor and in children who had not been pretreated who experienced disseminated relapse. Further studies of the role of 131-1 meta-Iodobenzylguanidine in treatment of neuroblastoma are needed. Cancer 67:922-928,1991.

ENZYLGUANIDINE IS

A guanethidine derivative se-B lectively concentrated by the cells of the sympathetic nervous system.' Since 1980, 1 3 1 -Iand 123-I-labeled benzylguanidine have been used for scintigraphic imaging of normal adrenal medulla,' and in the investigation of neoplasias of sympathetic nerve origin, such as pheo-chromo~ytoma,~ medullary thyroid c a r ~i n o m a , ~ parag a n g l i ~m a , ~ and n e u r o b l a ~t o m a . ~~~ 13 1-I-labeled meta-lodobenzylguanidine ( I3 I-MIBG) has subsequently been given tentatively as treatment for