Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
권호 표지
DOI QR코드

DOI QR Code

Palliative effect of 131I-MIBG in relapsed neuroblastoma after autologous peripheral blood stem cell transplantation

자가 말초혈조혈모세포이식 후 재발된 신경모세포종 3예에서 131I-MIBG의 고식적 치료 효과

  • Lee, Yong Jik (Department of Hematology/Oncology, Yeungnam University College of Medicine) ;
  • Hah, Jeong Ok (Department of Hematology/Oncology, Yeungnam University College of Medicine)
  • 이용직 (영남대학교 의과대학 소아과학교실) ;
  • 하정옥 (영남대학교 의과대학 소아과학교실)
  • Received : 2007.12.15
  • Accepted : 2008.01.19
  • Published : 2008.02.15
Download PDF
⟨ Previous Next ⟩

Abstract

Neuroblastoma is one of the most common extracranial solid tumor of childhood, and treatment of refractory neuroblastoma remains a significant clinical problem. Iodine-131-metaiodobenzylguanidine ($^{131}I-MIBG$) therapy is an alternative approach to treat stage IV neuroblastoma. We report the palliative effect of $^{131}I-MIBG$ in three cases of relapsed neuroblastoma after autologous peripheral blood stem cell transplantation. $^{131}I-MIBG$ is an effective and relatively nontoxic palliative therapy resulting in reduction of pain and prolongation of survival.

신경모세포종은 소아에서 발생하는 흔한 두개외 고형 종양 중 하나로서 진행된 경우 고용량 항암요법 및 자가 말초혈조혈모세포이식 후에도 재발이 잘 되어 예후가 매우 나쁘다. Iodine-131 metaiodobenzylguanidine ($^{131}I-MIBG$)는 치료에 잘 반응하지 않는 신경모세포종 4기 환자를 위한 대증적 치료 요법으로 제한적으로 이용되어 왔다. 저자들은 자가 말초혈조혈모세포이식 후 재발된 신경모세포종 3례에서 $^{131}I-MIBG$를 이용하여 통증을 경감시키고 생존 기간을 늘이는 고식적인 치료 효과를 얻어 이들에 대한 증례 보고를 하는 바이다.

Keywords

References

  1. Matthay KK, Villablanca JG, Seeger RC, Stram DO, Harris RE, Ramsay NK, et al. Treatment of high-risk neuroblastoma with intensive chemotherapy, radiotherapy, autologous bone marrow transplantation, and 13-cis-retinoic acid. N Engl J Med 1999;341:1165-73 https://doi.org/10.1056/NEJM199910143411601
  2. Klingebiel T, Bader P, Bares R, Beck J, Hero B, Jurgens H, et al. Treatment of neuroblastoma stage 4 with $^{131}$Imeta-iodo-benzylguanetidine, high dose chemotherapy and immunotherapy. A pilot study. Eur J Cancer 1998;34:1398-402 https://doi.org/10.1016/S0959-8049(98)00130-0
  3. Garaventa A, Guerra P, Arrighini A, Bertolazzi L, Bestagno M, De Bernardi B, et al. Treatment of advanced neuroblastoma with I-131 meta-iodobenzylguanidine. Cancer 1991;67:922-8 https://doi.org/10.1002/1097-0142(19910215)67:4<922::AID-CNCR2820670411>3.0.CO;2-D
  4. Yanik GA, Levine JE, Matthay KK, Sisson JC, Shulkin BL, Shapiro B, et al. Pilot study of iodine-131-metaiodobenzyl-guanidine in combination with myeloablative chemotherapy and autologous stem-cell support for the treatment of neuroblastoma. J Clin Oncol 2002;20:2142-9 https://doi.org/10.1200/JCO.2002.08.124
  5. Riley RD, Heney D, Jones DR, Sutton AJ, Lambert PC, Abrams KR, et al. A systematic review of molecular and biological tumor markers in neuroblastoma. Clin Cancer Res 2004;10:4-12 https://doi.org/10.1158/1078-0432.CCR-1051-2
  6. Matthay KK, Atkinson JB, Stram DO, Selch M, Reynolds CP, Seeger RC. Patterns of relapse after autologous purged bone marrow transplantation for neuroblastoma: a Childrens Cancer Group pilot study. J Clin Oncol 1993;11:2226-33 https://doi.org/10.1200/JCO.1993.11.11.2226
  7. Hickeson MP, Charron M, Maris JM, Brophy P, Kang TI, Zhuang H, et al. Biodistribution of post-therapeutic versus diagnostic $^{131}$I-MIBG scans in children with neuroblastoma. Pediatr Blood Cancer 2004;42:268-74 https://doi.org/10.1002/pbc.10454
  8. Matthay KK, DeSantes K, Hasegawa B, Huberty J, Hattner RS, Ablin A, et al. Phase I dose escalation of $^{131}$I-metaiodobenzylguanidine with autologous bone marrow support in refractory neuroblastoma. J Clin Oncol 1998;16:229-36 https://doi.org/10.1200/JCO.1998.16.1.229
  9. Howard JP, Maris JM, Kersun LS, Huberty JP, Cheng SC, Hawkins RA, et al. Tumor response and toxicity with multiple infusions of high dose 131I-MIBG for refractory neuroblastoma. Pediatr Blood Cancer 2005;44:232-9 https://doi.org/10.1002/pbc.20240
  10. Troncone L, Galli G. The role of [131I]Metaiodobenzylguanidine in the treatment of neural crest tumors. Proceedings of an international workshop. Rome, Italy, September 6-7, 1991. J Nucl Biol Med 1991;35:177-363
  11. Tepmongkol S, Heyman S. 131I MIBG therapy in neuroblastoma: mechanisms, rationale, and current status. Med Pediatr Oncol 1999;32:427-31 https://doi.org/10.1002/(SICI)1096-911X(199906)32:6<427::AID-MPO6>3.0.CO;2-T
  12. Klingebiel T, Berthold F, Treuner J, Schwabe D, Fischer M, Feine U, et al. Metaiodobenzylguanidine (MIBG) in treatment of 47 patients with neuroblastoma: results of the German Neuroblastoma Trial. Med Pediatr Oncol 1991;19:84-8 https://doi.org/10.1002/mpo.2950190203
  13. Kang TI, Brophy P, Hickeson M, Heyman S, Evans AE, Charron M, et al. Targeted radiotherapy with submyeloablative doses of $^{131}$I-MIBG is effective for disease palliation in highly refractory neuroblastoma. J Pediatr Hematol Oncol 2003;25:769-73 https://doi.org/10.1097/00043426-200310000-00005
  14. De Kraker J, Hoefnagel CA, Caron H, Valdes Olmos RA, Zsiros J, Heij HA, et al. First line targeted radiotherapy, a new concept in the treatment of advanced stage neuroblastoma. Eur J Cancer 1995;31:600-2 https://doi.org/10.1016/0959-8049(95)00063-O
  15. Matthay KK, Yanik G, Messina J, Quach A, Huberty J, Cheng SC, et al. Phase II study on the effect of disease sites, age, and prior therapy on response to iodine-131-metaiodobenzylguanidine therapy in refractory neuroblastoma. J Clin Oncol 2007;25:1054-60 https://doi.org/10.1200/JCO.2006.09.3484
  16. Matthay KK, Tan JC, Villablanca JG, Yanik GA, Veatch J, Franc B, et al. Phase I dose escalation of iodine-131-metaiodobenzylguanidine with myeloablative chemotherapy and autologous stem-cell transplantation in refractory neuroblastoma: a new approaches to Neuroblastoma Therapy Consortium Study. J Clin Oncol 2006;24:500-6 https://doi.org/10.1200/JCO.2005.03.6400
  17. Weiss B, Vora A, Huberty J, Hawkins RA, Matthay KK. Secondary myelodysplastic syndrome and leukemia following 131I-metaiodobenzylguanidine therapy for relapsed neuroblastoma. J Pediatr Hematol Oncol 2003;25:543-7 https://doi.org/10.1097/00043426-200307000-00009
  18. Hall P, Holm LE. Cancer in iodine-131 exposed patients. J Endocrinol Invest 1995;18:147-9 https://doi.org/10.1007/BF03349726