A Case of Malignant Pheochromocytoma Treated by<sup>131</sup>I-Metaiodobenzylguanidine

Theilade, Karen; Bak, Mogens; Olsen, K. N.; Nielsen, Steen Levin; Christensen, Niels Juul

doi:10.3109/02841868809093542

Cited by 6 publications

(1 citation statement)

References 5 publications

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“…Although the range of the 125I Auger electrons in the storage vesicles would seem to be inadequate to deliver a meaningful radiation dose to the nucleus, the finding that in neuroblastoma extragranular storage contributes considerably to the total MIBG retention (Smets et al 1989) may provide a basis for this treatment. Table 4 shows the observed response to ~ 3 ~I-MIBG therapy in 66 patients worldwide with malignant pheochromocytoma, as reported in the literature (Sisson et al 1984;Beierwaltes W H 1985a;Jakubowski et al 1985;Fischer and Vetter 1986;Hoefnagel et al 1987a;Marchandise et al 1987;Kimmig 1988;Theilade et al 1988;Naeem et al 1989;Troncone et al 1990; K r e m p f et al 199~ ; Ackery and Lewington 1991). Arrest and slight regression of disease ( Fig.…”

Section: Neuroblastomamentioning

confidence: 83%

Radionuclide therapy revisited

Hoefnagel

1991

Eur J Nucl Med

123

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Apart from its use in endocrinology and rheumatology, therapeutic nuclear medicine is developing rapidly as an additional treatment modality in oncology. Many different specific tumour-seeking radiopharmaceuticals are being applied both for diagnostic scintigraphy and treatment, using multiple routes and mechanisms to target radionuclides at tumours. After a brief introduction of some basic principles of radionuclide targeting, the therapeutic radiopharmaceuticals available are reviewed according to the accumulation site in relation to the cell nucleus; the results of their current clinical use for therapy are also reviewed. The response observed to a number of these applications, the non-invasiveness of the procedure and the relative lack of toxicity and late effects in comparison with chemotherapy and external beam radiotherapy make radionuclide therapy an attractive and realistic alternative in the management of malignant disease, as well as in the treatment of a few benign disorders.

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Section: Neuroblastomamentioning

confidence: 83%

Radionuclide therapy revisited

Hoefnagel

1991

Eur J Nucl Med

123

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The treatment of malignant pheochromocytoma with Iodine-131 metaiodobenzylguanidine (131I-MIBG): A comprehensive review of 116 reported patients

Loh

FitzGerald

Matthay

et al. 1997

J Endocrinol Invest

257

148

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Iodine-131 metaiodobenzylguanidine (131I-MIBG), a radiopharmaceutical agent used for scintigraphic localization of pheochromocytomas, has been employed to treat malignant pheochromocytomas since 1983 in a few specialized centers around the world. We review our clinical experience together with the published experience of 23 other centers in 10 countries, regarding the use of 1311-MIBG for treating patients with malignant adrenal pheochromocytomas or extra-adrenal paragangliomas. There were a total of 116 evaluable patients: 3 were from our current report and another 113 were reported in the literature from 1983 to 1996. A majority of the patients were selected for treatment based upon positive tracer uptake studies. The cumulative dose of 131I-MIBG administered ranged from 96 to 2,322 mCi (3.6 to 85.9 GBq), with a mean (+/-SD) of 490+/-350 mCi (18.1+/-13.0 GBq). The subjects received a mean single therapy dose of 158 mCi (5.8 GBq) and the number of doses administered ranged from 1 to 11, with a mean of 3.3+/-2.2 doses. Initial symptomatic improvement was achieved in 76% of patients, tumor responses in 30%, and hormonal responses in 45%. Five patients had complete tumor and hormonal responses, ranging from 16 to 58 months, which were sustained at the time of reporting. Patients with metastases to soft tissue had more favorable responses to treatment than those with metastases to bone. No difference was noted in the age between the responders and non-responders. Adverse effects, recorded in 41% of the treated patients, were generally mild except for one fatality from bone marrow aplasia. Among 89 patients with follow-up data, 45% of the responders had relapsed with recurrent or progressive disease after a mean interval of 29.3+/-31.1 months (median 19 months). Of patients with an initial response to 1311-MIBG, death was reported in 33% after a mean of 23.2+/-8.1 months (median 22 months) following treatment. Of non-responders, death was reported in 45% after a mean of 14.3+/-8.3 months (median 13 months). In conclusion, this review suggests that 131I-MIBG therapy may be a useful palliative adjunct in selected patients with malignant pheochromocytoma or paraganglioma. Although controlled studies are lacking, our review raises the hope that this therapeutic modality may prolong survival with an occasional sustained complete remission or possible cure.

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