Second malignancies in children with neuroblastoma after combined treatment with 131I-metaiodobenzylguanidine
Second malignancies in children with neuroblastoma after combined treatment with 131I-metaiodobenzylguanidine
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DOI：
10.1002/cncr.11167
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发表时间：
2003-03-01
期刊：
影响因子：
6.2
通讯作者：
Haupt, R
中科院分区：
文献类型：
--
作者：
Garaventa, A;Gambini, C;Haupt, R
背景。I-131-metaiodobenzylguanidine （I-131-MIBG）被神经嵴来源的细胞选择性吸收，允许对神经母细胞瘤（NB）和嗜铬细胞瘤等肿瘤进行靶向放疗。放疗可以为NB的治疗提供额外的好处，但副作用适中，如血液和甲状腺毒性。然而，随着随访时间的延长，可能会出现其他并发症。我们描述了我们在接受I-131-MIBG和化疗治疗的儿童中发生的第二种癌症的经验。我们回顾了1984年至2001年间在同一医院连续接受I-131-MIBG治疗的119例NB患者的临床记录，以确定是否发生第二恶性肿瘤（SMN）。总的来说，研究患者中发生了5例SMN。其中髓性白血病2例，血管瘤性纤维组织细胞瘤1例，恶性神经鞘瘤1例，横纹肌肉瘤1例。在一线治疗后，神经鞘瘤和横纹肌肉瘤在残留的神经母细胞肿块中发生。如果I-131-MIBG治疗在神经母细胞瘤的治疗策略中得到更广泛的应用，则必须考虑到二次癌的风险。对接受I-131-MBG治疗的受试者进行国际注册的组织可能会更好地定义这种放射代谢方法后第二恶性肿瘤的频率和特征。(C) 2003年美国癌症协会。
BACKGROUND. I-131-metaiodobenzylguanidine (I-131-MIBG) is selectively taken up by cells of neural crest origin, allowing targeted radiotherapy of tumors such as neuroblastoma (NB) and pheochromocytoma. Radiotherapy may provide additional benefits in the treatment of NB, with moderate side effects such as hematologic and thyroid toxicity. However, with longer follow-up, other complications might occur. We describe our experience with second cancers occurring in children treated with I-131-MIBG and chemotherapy.METHODS. The clinical records of 119 consecutive NB cases treated with I-131-MIBG at a single institution between 1984 and 2001 were reviewed for the occurrence of a second malignant neoplasm (SMN).RESULTS. Overall, five cases of SMN occurred in the study patients. In particular, two cases of myeloid leukemia, one of angiomatous fibrous histiocytoma, one of malignant schwannoma, and one case of rhabdomyosarcoma were detected. The schwannoma and the rhabdomyosarcoma developed within the residual neuroblastic mass after first-line therapy.CONCLUSIONS. Should I-131-MIBG treatment become more broadly employed in the therapeutic strategy for neuroblastoma, the risk of second cancer will have to be taken into consideration. The organization of an international registry of subjects treated with I-131-MBG might better define the frequency and features of second malignancies following this radiometabolic approach. (C) 2003 American Cancer Society.