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131I-间碘苄胍治疗转移性嗜铬细胞瘤和副神经节瘤

131I-MIBG therapy in metastatic phaeochromocytoma and paraganglioma.

作者信息

Gedik Gonca Kara, Hoefnagel Cornelis A, Bais Evert, Olmos Renato A Valdés

机构信息

Department of Nuclear Medicine, Faculty of Medicine, Hacettepe University School of Medicine, Sihhiye 06100 Ankara, Turkey.

出版信息

Eur J Nucl Med Mol Imaging. 2008 Apr;35(4):725-33. doi: 10.1007/s00259-007-0652-6. Epub 2007 Dec 11.

Abstract

PURPOSE

(131)Iodine metaiodobenzylguanidine ((131)I-MIBG) is a radiopharmaceutical used for scintigraphic localisation of phaeochromocytomas and paragangliomas. The experience with its therapeutic use is limited. We report our experience for the treatment of malignant phaeochromocytoma and paraganglioma.

MATERIALS AND METHODS

The charts of 19 patients with malignant phaeochromocytoma (n = 12) or paraganglioma (n = 7), who were treated with (131)I-MIBG, were retrospectively reviewed. Four patients (21%) received radiotherapy, three (16%) chemotherapy, and in one patient (5%), both chemotherapy and radiotherapy was given before (131)I-MIBG therapy. Response to (131)I-MIBG treatment was evaluated by objective as tumour response, biochemical and subjective response.

RESULTS

Of the 19 patients, 13 (68%) were men, 6 (32%) were women. Ages ranged from 22 to 68 years (median, 47). The median initial dose was 7.4 GBq (200 mCi; range, 6.7 GBq-25.9 GBq, 180-700 mCi); median cumulative dose was 22.2 GBq (600 mCi; range, 6.8 GBq-81.4 GBq, 183-2200 mCi). Objective tumour response was achieved in 47% of the patients. Biochemical response rate was 67%, and symptomatic response was seen in 89% of the patients. Overall median follow-up was 29 months, with a range of 3-93 months. Haematologic complications were the most common side effects and were observed in 26% of the patients.

CONCLUSION

Our data support that symptomatic and biochemical response can be reached with (131)I-MIBG therapy in patients with metastatic phaeochromocytoma and paraganglioma. Although complete tumour response was not observed, the palliation and control of tumour function by (131)I-MIBG therapy may be valuable for the patients.

摘要

目的

碘间碘苄胍(¹³¹I-MIBG)是一种用于嗜铬细胞瘤和副神经节瘤闪烁显像定位的放射性药物。其治疗用途的经验有限。我们报告我们治疗恶性嗜铬细胞瘤和副神经节瘤的经验。

材料与方法

回顾性分析19例接受¹³¹I-MIBG治疗的恶性嗜铬细胞瘤患者(n = 12)或副神经节瘤患者(n = 7)的病历。4例患者(21%)接受了放疗,3例(16%)接受了化疗,1例患者(5%)在¹³¹I-MIBG治疗前接受了化疗和放疗。通过客观的肿瘤反应、生化反应和主观反应来评估¹³¹I-MIBG治疗的反应。

结果

19例患者中,13例(68%)为男性,6例(32%)为女性。年龄范围为22至68岁(中位数为47岁)。初始剂量中位数为7.4 GBq(200 mCi;范围为6.7 GBq - 25.9 GBq,180 - 700 mCi);累积剂量中位数为22.2 GBq(600 mCi;范围为6.8 GBq - 81.4 GBq,183 - 2200 mCi)。47%的患者实现了客观肿瘤反应。生化反应率为67%,89%的患者有症状缓解。总体随访中位数为29个月,范围为3至93个月。血液学并发症是最常见的副作用,26%的患者出现了该并发症。

结论

我们的数据支持¹³¹I-MIBG治疗转移性嗜铬细胞瘤和副神经节瘤患者可实现症状和生化反应。虽然未观察到肿瘤完全缓解,但¹³¹I-MIBG治疗对肿瘤功能的缓解和控制可能对患者有价值。

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