Treatment of malignant pheochromocytomas with 131-I metaiodobenzylguanidine and chemotherapy
Treatment of malignant pheochromocytomas with 131-I metaiodobenzylguanidine and chemotherapy
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DOI：
10.1097/00000421-199908000-00008
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发表时间：
1999-08-01
影响因子：
2.6
通讯作者：
Spaulding, S
中科院分区：
文献类型：
--
作者：
Sisson, JC;Shapiro, B;Spaulding, S
恶性嗜铬细胞瘤对 131-I 间碘苄胍 (MIBG) 和化疗显示出部分反应。作者将这两种治疗方法结合起来，以确定每种方法的有益效果是否会相加。招募患有恶性嗜铬细胞瘤的患者，目的是每隔 3 个月施用 3 种大量放射性的 131-I MIBG，然后进行一年的化疗，其中以 21 天为周期给予环磷酰胺、达卡巴嗪和长春新碱。六名患者参加了协议。 131-I MIBG治疗后，3名患者出现肿瘤存在（肿瘤体积变小或骨和131-I MIBG扫描异常）和肿瘤功能下降（主要指标是去甲肾上腺素排泄率下降）。两名患者完成了至少 9 个月的化疗，肿瘤的存在和功能进一步减少，被归类为部分缓解。其他四名受试者中的三名患有进行性疾病。尽管 131-I MIBG 的毒性很小，但足以迫使化疗剂量或持续时间减少。 131-I MIBG 治疗和化疗相结合，在减少恶性嗜铬细胞瘤方面产生了叠加效应。毒性适度限制了拟议的化疗方案。
Malignant pheochromocytomas have exhibited partial responses to treatments with 131-I metaiodobenzylguanidine (MIBG) and with chemotherapy. The authors combined these two therapeutic methods to determine if beneficial effects from each would be additive. Patients with documented malignant pheochromocytomas were recruited with the intent of administering 131-I MIBG in three substantial amounts of radioactivity at 3-month intervals followed by a year of chemotherapy in which cyclophosphamide, dacarbazine, and vincristine were to be given in 21-day cycles. Six patients entered the protocol. After the 131-I MIBG treatments, three patients manifested declines in the presence of tumor (smaller tumor volume or abnormalities on bone and 131-I MIBG scans) and the function of tumor (decreased rate of normetanephrine excretion as the major index). Two patients completed at least 9 months of chemotherapy and showed further reductions in the presence and function of tumors and were classified as having partial responses. Progressive disease afflicted three of the other four subjects. Even though toxicity was minimal from 131-I MIBG, it was sufficient to force reduction in the dosages or duration of chemotherapy. A combination of 131-I MIBG treatments and chemotherapy produced additive effects in reducing malignant pheochromocytomas. Toxicity moderately curtailed the proposed chemotherapy protocol.