Background:131I-meta-iodobenzylguanidine (131I-MIBG) has been in therapeutic use since 1980s. Newer treatment modalities are emerging for neuroendocrine tumours (NETs) and chromaffin cell tumours (CCTs), but many of these do not yet have adequate long-term follow-up to determine their longer term efficacy and sequelae.Methods:Fifty-eight patients with metastatic NETs and CCTs who had received 131I-MIBG therapy between 2000 and 2011 were analysed. Survival and any long-term haematological or renal sequelae were investigated.Results:In the NET group, the overall median survival and median survival following the diagnosis of metastatic disease was 124 months. The median survival following the commencement of 131I-MIBG was 66 months. For the CCT group, median survival had not been reached. The 5-year survival from diagnosis and following the diagnosis of metastatic disease was 67% and 67.5% for NETs and CCTs, respectively. The 5-year survival following the commencement of 131I-MIBG therapy was 68%. Thirty-two patients had long-term haematological sequelae: 5 of these 32 patients developed haematological malignancies. Two patients developed a mild deterioration in renal function.Conclusion:Long follow up of 131I-MIBG therapy reveals a noteable rate of bone marrow toxicities and malignancy and long term review of all patients receiving radionuclide therapies is recommended.

Objectives:To review the outcome of patients with locally advanced rectal cancer who underwent short-course preoperative radiotherapy (SCPRT) with delayed total mesorectal excision. Methods: Consecutive patients with locally advanced rectal cancer who underwent SCPRT with delayed surgery between January 2011 and November 2014 in Tuen Mun Hospital were retrospectively reviewed. Results: Overall, 18 men and five women aged 36 to 88 years underwent SCPRT with delayed surgery owing to advanced age (n = 10), poor performance status (n = 7), and severe comorbidity (n = 6). All patients had at least one risk factor: threatened mesorectal fascia (n = 20), tumour stage 4 (n = 4), lymph node stage 2 (n = 7), and low-lying tumour (n = 5). After SCPRT, 19 of the 23 patients underwent anterior resection (n = 13) or abdominalperianal resection (n = 6) at a median of 11 weeks and achieved R0 (n = 17) or R1 (n = 2) resection. During a median follow-up of 13 months, eight patients died due to metastasis (n = 5), medical condition without evidence of progression (n = 2), or postoperative complications (n = 1). The median survival time of the 23 patients was 34 months. The 1-year overall survival was 75.1%; the 1-year cancer-specific survival was 82.5%; and the 1-year progression-free survival was 79.3%. In 19 patients who underwent resection, six developed metastatic disease. Two patients had local recurrence who also had synchronous distant metastasis. All patients completed SCPRT without interruption. Two patients had grade 3 or above toxicity: one had perforated bowel requiring emergency operation at 3 weeks and another had grade 3 leukopenia without evidence of sepsis. In the postoperative period (≤30 days), eight patients developed surgical complications including anastomotic leakage (n = 2), septic complications (n = 3), persistent perianal infection (n = 1), and ileus (n = 2). One patient died at postoperative day 12 due to myocardial infarction. One patient developed severe late radiotherapy-related toxicity of burst stump and pelvic abscess at 5 months. Conclusion: SCPRT with delayed surgery can downsize and downstage locally advanced rectal cancer and achieve a favourable toxicity profile. It is a viable option for patients who are unfit for preoperative long-course chemoradiotherapy.