131I-MIBG Therapy in metastatic phaeochromocytoma and paraganglioma
131I-MIBG Therapy in metastatic phaeochromocytoma and paraganglioma
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DOI：
10.1007/s00259-007-0652-6
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发表时间：
2008-04-01
影响因子：
9.1
通讯作者：
Olmos, Renato A. Valdes
中科院分区：
文献类型：
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作者：
Gedik, Gonca Kara;Hoefnagel, Cornelis A.;Olmos, Renato A. Valdes
目的(131)间碘苯甲基胍(I-131-MIBG)是一种放射性药物，用于嗜铬细胞瘤和副神经节瘤的放射性定位。其治疗应用的经验是有限的。资料与方法回顾分析了19例恶性嗜铬细胞瘤(12例)或副神经节瘤(7例)行I-131-MIBG治疗的临床资料。4名患者(21%)接受放射治疗，3名患者(16%)接受化疗，1名患者(5%)在I-131-MIBG治疗前同时接受化疗和放射治疗。结果19例患者中，男性13例(68%)，女性6例(32%)。年龄从22岁到68岁(中位数47岁)。中位初始剂量为7.4GBq(200mCI；范围为6.7GBq~25.9GBq，180~700mCI)；中位累积剂量为22.2GBq(600mCI；范围6.8GBq~81.4GBq，183~2200mCI)。目的肿瘤缓解率为47%。生化反应率为67%，89%的患者出现症状反应。总的中位随访期为29个月，范围为3-93个月。血液学并发症是最常见的副作用，发生率为26%。结论I-131-MIBG治疗转移性嗜铬细胞瘤和副神经节细胞瘤可以达到症状和生化反应。虽然未观察到肿瘤的完全反应，但I-131-MIBG对肿瘤功能的缓解和控制对患者可能是有价值的。
Purpose (131)Iodine metaiodobenzylguanidine (I-131-MIBG) is a radiopharmaceutical used for scintigraphic localisation of phaeochromocytomas and paragangliomas. The experience with its therapeutic use is limited. We report our experience for the treatment of malignant phaeochromocytoma and paraganglioma.Materials and methods The charts of 19 patients with malignant phaeochromocytoma (n=12) or paraganglioma (n=7), who were treated with I-131-MIBG, were retrospectively reviewed. Four patients (21%) received radiotherapy, three (16%) chemotherapy, and in one patient (5%), both chemotherapy and radiotherapy was given before I-131-MIBG therapy. Response to I-131-MIBG treatment was evaluated by objective as tumour response, biochemical and subjective response.Results Of the 19 patients, 13 (68%) were men, 6 (32%) were women. Ages ranged from 22 to 68 years (median, 47). The median initial dose was 7.4 GBq (200 mCi; range, 6.7 GBq-25.9 GBq, 180-700 mCi); median cumulative dose was 22.2 GBq (600 mCi; range, 6.8 GBq-81.4 GBq, 183-2200 mCi). Objective tumour response was achieved in 47% of the patients. Biochemical response rate was 67%, and symptomatic response was seen in 89% of the patients. Overall median follow-up was 29 months, with a range of 3-93 months. Haematologic complications were the most common side effects and were observed in 26% of the patients.Conclusion Our data support that symptomatic and biochemical response can be reached with I-131-MIBG therapy in patients with metastatic phaeochromocytoma and paraganglioma. Although complete tumour response was not observed, the palliation and control of tumour function by I-131-MIBG therapy may be valuable for the patients.