학술논문
Efficacy and Safety of 124 I-MIBG Dosimetry-Guided High-Activity 131 I-MIBG Therapy of Advanced Pheochromocytoma or Neuroblastoma.
Document Type
Academic Journal
Author
Maric I; Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany; ines.maric@uk-essen.de.; German Cancer Consortium (DKTK), partner site, Essen, Germany.; Weber M; Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; German Cancer Consortium (DKTK), partner site, Essen, Germany.; Prochnow A; Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; Schmitz J; Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; German Cancer Consortium (DKTK), partner site, Essen, Germany.; Unger N; German Cancer Consortium (DKTK), partner site, Essen, Germany.; Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; Schaarschmidt BM; German Cancer Consortium (DKTK), partner site, Essen, Germany.; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany; and.; Poeppel TD; Nuklearmedizin, MVZ CDT Strahleninstitut, Cologne, Germany.; Rischpler C; Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; German Cancer Consortium (DKTK), partner site, Essen, Germany.; Bockisch A; Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; German Cancer Consortium (DKTK), partner site, Essen, Germany.; Herrmann K; Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; German Cancer Consortium (DKTK), partner site, Essen, Germany.; Jentzen W; Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; German Cancer Consortium (DKTK), partner site, Essen, Germany.; Fendler WP; Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; German Cancer Consortium (DKTK), partner site, Essen, Germany.
Source
Publisher: Society of Nuclear Medicine Country of Publication: United States NLM ID: 0217410 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-5667 (Electronic) Linking ISSN: 01615505 NLM ISO Abbreviation: J Nucl Med Subsets: MEDLINE
Subject
Language
English
Abstract
We aim to evaluate the efficacy and safety of 124 I-metaiodobenzylguanidine (MIBG) dosimetry-guided high-activity 131 I-MIBG therapy of advanced pheochromocytoma or neuroblastoma. Methods: Fourteen patients with advanced pheochromocytoma or neuroblastoma, age 9-69 y, underwent 124 I-MIBG PET scans and whole-body retention measurements to assess the whole-body dose as a surrogate of bone marrow toxicity and tumor (absorbed) dose per unit of administered activity. Dosimetry results together with individual patient characteristics were combined to guide a single therapeutic activity to achieve a high tumor dose without exceeding toxicity threshold. Toxicity was assessed for hematologic, hepatic, and renal function. Response was evaluated by RECIST, International Society of Pediatric Oncology Europe Neuroblastoma-like score, change in PET uptake, and quantitative PET parameters (SUV max , SUV peak , metabolic tumor volume, total lesion glycolysis), as well as visual decrease in number or in visual intensity of lesions on baseline to follow-up 124 I-MIBG PET/CT. Results: The average therapeutic activity was 14 GBq. Eleven of 14 patients (79%) received each more than 10 GBq. One male patient was treated with a single activity of 50 GBq. Three patients were treated with lower activities between 3.5 and 7.0 GBq. Median overall survival was 85 mo (95% CI), and median progression-free survival was 25 mo (95% CI). Four (29%) and 5 (36%) patients demonstrated response (complete response or partial response) by RECIST and functional imaging, respectively. One patient exceeded whole-body dose of 2 Gy and demonstrated grade 3 hematologic toxicity, which resolved spontaneously within 12 mo after the therapy without the need for further treatment. Three patients (21%) demonstrated transient grade 1 renal toxicity. Conclusion: 124 I-MIBG dosimetry-guided high-activity 131 I-MIBG therapy in patients with advanced pheochromocytoma or neuroblastoma resulted in durable responses with a low rate of manageable adverse events. Efficacy of 124 I-MIBG-guided activity escalation should further be assessed in a prospective setting.
(© 2023 by the Society of Nuclear Medicine and Molecular Imaging.)
(© 2023 by the Society of Nuclear Medicine and Molecular Imaging.)