I-131 MIBG Therapy for Advanced Stage III & IV Neuroblastoma

Abstract

Radio-labelled MIBG therapy has been tried in the treatment of advanced stage III and IV neuroblastoma in an attempt to improve patients outcome. The use of radiolabelled MIBG to treat neuroblastoma has arisen from the high sensitivity and specificity of in vivo MIBG imaging for detection of primary and metastatic tumours. Although, clinical trials have been performed to determine the role of MIBG therapy, the overall therapeutic strategy of MIBG therapy is not precisely defined. Aim of the work: to determine the impact of MIBG therapy on patients’ outcome especially their quality of life. Patients & methods: 42 paediatri neuroblastoma patients are included in this study, 12 (28.5%) stage III disease and 30 (71.5%) stage IV. I-131 MIBG doses ranged from 100 to 150 mCi with number of courses ranged from 1-8 according to response and toxicity. Results: Group I (stage III): 1/12 patients showed complete response, 5/12 patients had partial response and the other 6 patients remained stable. The 5 years event free survival (EFS) of stage III patients was 46.6% and the overall survival was 75%. Group II (stage IV): 2/30 patients achieved CR, 9/30 patients showed PR to I-131 MIBG and the other 18 remained stable. The 5 years event free survival (EFS) of stage IV patients was 48.2% and the overall survival was 69%. Conclusion: We conclude that 131I-MIBG therapy has favourable therapeutic effects that are translated into an overall improved outcome with good quality of life.