Treatment of metastatic carcinoid tumours, phaeochromocytoma, paraganglioma and medullary carcinoma of the thyroid with (131)I-meta-iodobenzylguanidine [(131)I-mIBG].
OBJECTIVE: Meta-iodo-benzyl-guanidine labelled with 131-iodine [(131)I-mIBG] has been used extensively for imaging tumours originating from the neural crest but experience with its therapeutic use is limited, particularly for non-catecholamine secreting tumours. In order to assess the therapeutic re...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2001
|
| _version_ | 1797056336868933632 |
|---|---|
| author | Mukherjee, J Kaltsas, G Islam, N Plowman, P Foley, R Hikmat, J Britton, K Jenkins, P Chew, S Monson, J Besser, G Grossman, AB |
| author_facet | Mukherjee, J Kaltsas, G Islam, N Plowman, P Foley, R Hikmat, J Britton, K Jenkins, P Chew, S Monson, J Besser, G Grossman, AB |
| author_sort | Mukherjee, J |
| collection | OXFORD |
| description | OBJECTIVE: Meta-iodo-benzyl-guanidine labelled with 131-iodine [(131)I-mIBG] has been used extensively for imaging tumours originating from the neural crest but experience with its therapeutic use is limited, particularly for non-catecholamine secreting tumours. In order to assess the therapeutic response and potential adverse effects of the therapeutic administration of (131)I-mIBG, we have reviewed all patients who had received this form of treatment in our department. DESIGN: Retrospective analysis of the case notes of patients with neuroendocrine tumours who received treatment with (131)I-mIBG and were followed-up according to a defined protocol in a given time frame. PATIENTS: Thirty-seven patients (18 with metastatic carcinoid tumours, 8 metastatic phaeochromocytoma, 7 metastatic paraganglioma and 4 metastatic medullary carcinoma of the thyroid) treated with (131)I-mIBG over a 15-year period were included in this analysis. MEASUREMENTS: The symptomatic, hormonal and tumoural responses before and after (131)I-mIBG therapy over a median follow-up duration of 32 months (range 5-180 months) were recorded. Of the 37 patients (22 males; median age 51 years, range 18-81 years), 15 were treated with (131)I-mIBG alone whereas the other 22 received additional therapy. RESULTS: A total of 116 therapeutic (131)I-mIBG doses were administered [mean cumulative dose 592 mCi (21.9 GBq); range 200-1592 mCi (7.4-58.9 GBq)]. None of the patients showed a complete tumour response. However, 82% of patients treated with (131)I-mIBG alone and 84% who received additional therapy showed stable disease over the period of follow-up. Overall survival during the period of the study was 71%. The overall 5-year survival rate was 85% (95% confidence interval, 72-99%) for all patients and 78% (95% confidence interval, 55-100%) for the carcinoid group alone, according to Kaplan-Meier analysis. Symptomatic control was achieved in all the patients treated with (131)I-mIBG alone, and in 72% of those receiving additional therapy. Hormonal control was noted in 50% and 57% of patients, respectively. (131)I-mIBG therapy was safe and well tolerated. Serious side-effects necessitating the termination of (131)I-mIBG therapy were seen in only 2 of our patients. CONCLUSIONS: (131)I-mIBG therapy produces symptomatic and hormonal improvement and moderate tumour regression/stabilization in patients with metastatic neuroendocrine tumours with minimal adverse effects. It may be a valuable alternative or additional therapeutic option to the currently available conventional treatment modalities. |
| first_indexed | 2024-03-06T19:21:57Z |
| format | Journal article |
| id | oxford-uuid:1a674eb9-cd48-4c59-88ed-6264355e685b |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:21:57Z |
| publishDate | 2001 |
| record_format | dspace |
| spelling | oxford-uuid:1a674eb9-cd48-4c59-88ed-6264355e685b2022-03-26T10:54:39ZTreatment of metastatic carcinoid tumours, phaeochromocytoma, paraganglioma and medullary carcinoma of the thyroid with (131)I-meta-iodobenzylguanidine [(131)I-mIBG].Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1a674eb9-cd48-4c59-88ed-6264355e685bEnglishSymplectic Elements at Oxford2001Mukherjee, JKaltsas, GIslam, NPlowman, PFoley, RHikmat, JBritton, KJenkins, PChew, SMonson, JBesser, GGrossman, ABOBJECTIVE: Meta-iodo-benzyl-guanidine labelled with 131-iodine [(131)I-mIBG] has been used extensively for imaging tumours originating from the neural crest but experience with its therapeutic use is limited, particularly for non-catecholamine secreting tumours. In order to assess the therapeutic response and potential adverse effects of the therapeutic administration of (131)I-mIBG, we have reviewed all patients who had received this form of treatment in our department. DESIGN: Retrospective analysis of the case notes of patients with neuroendocrine tumours who received treatment with (131)I-mIBG and were followed-up according to a defined protocol in a given time frame. PATIENTS: Thirty-seven patients (18 with metastatic carcinoid tumours, 8 metastatic phaeochromocytoma, 7 metastatic paraganglioma and 4 metastatic medullary carcinoma of the thyroid) treated with (131)I-mIBG over a 15-year period were included in this analysis. MEASUREMENTS: The symptomatic, hormonal and tumoural responses before and after (131)I-mIBG therapy over a median follow-up duration of 32 months (range 5-180 months) were recorded. Of the 37 patients (22 males; median age 51 years, range 18-81 years), 15 were treated with (131)I-mIBG alone whereas the other 22 received additional therapy. RESULTS: A total of 116 therapeutic (131)I-mIBG doses were administered [mean cumulative dose 592 mCi (21.9 GBq); range 200-1592 mCi (7.4-58.9 GBq)]. None of the patients showed a complete tumour response. However, 82% of patients treated with (131)I-mIBG alone and 84% who received additional therapy showed stable disease over the period of follow-up. Overall survival during the period of the study was 71%. The overall 5-year survival rate was 85% (95% confidence interval, 72-99%) for all patients and 78% (95% confidence interval, 55-100%) for the carcinoid group alone, according to Kaplan-Meier analysis. Symptomatic control was achieved in all the patients treated with (131)I-mIBG alone, and in 72% of those receiving additional therapy. Hormonal control was noted in 50% and 57% of patients, respectively. (131)I-mIBG therapy was safe and well tolerated. Serious side-effects necessitating the termination of (131)I-mIBG therapy were seen in only 2 of our patients. CONCLUSIONS: (131)I-mIBG therapy produces symptomatic and hormonal improvement and moderate tumour regression/stabilization in patients with metastatic neuroendocrine tumours with minimal adverse effects. It may be a valuable alternative or additional therapeutic option to the currently available conventional treatment modalities. |
| spellingShingle | Mukherjee, J Kaltsas, G Islam, N Plowman, P Foley, R Hikmat, J Britton, K Jenkins, P Chew, S Monson, J Besser, G Grossman, AB Treatment of metastatic carcinoid tumours, phaeochromocytoma, paraganglioma and medullary carcinoma of the thyroid with (131)I-meta-iodobenzylguanidine [(131)I-mIBG]. |
| title | Treatment of metastatic carcinoid tumours, phaeochromocytoma, paraganglioma and medullary carcinoma of the thyroid with (131)I-meta-iodobenzylguanidine [(131)I-mIBG]. |
| title_full | Treatment of metastatic carcinoid tumours, phaeochromocytoma, paraganglioma and medullary carcinoma of the thyroid with (131)I-meta-iodobenzylguanidine [(131)I-mIBG]. |
| title_fullStr | Treatment of metastatic carcinoid tumours, phaeochromocytoma, paraganglioma and medullary carcinoma of the thyroid with (131)I-meta-iodobenzylguanidine [(131)I-mIBG]. |
| title_full_unstemmed | Treatment of metastatic carcinoid tumours, phaeochromocytoma, paraganglioma and medullary carcinoma of the thyroid with (131)I-meta-iodobenzylguanidine [(131)I-mIBG]. |
| title_short | Treatment of metastatic carcinoid tumours, phaeochromocytoma, paraganglioma and medullary carcinoma of the thyroid with (131)I-meta-iodobenzylguanidine [(131)I-mIBG]. |
| title_sort | treatment of metastatic carcinoid tumours phaeochromocytoma paraganglioma and medullary carcinoma of the thyroid with 131 i meta iodobenzylguanidine 131 i mibg |
| work_keys_str_mv | AT mukherjeej treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT kaltsasg treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT islamn treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT plowmanp treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT foleyr treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT hikmatj treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT brittonk treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT jenkinsp treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT chews treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT monsonj treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT besserg treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg AT grossmanab treatmentofmetastaticcarcinoidtumoursphaeochromocytomaparagangliomaandmedullarycarcinomaofthethyroidwith131imetaiodobenzylguanidine131imibg |