Department of Nuclear Medicine, University Hospital, Bonn, Germany.
Radiat Oncol. 2012 Jan 25;7:8. doi: 10.1186/1748-717X-7-8.
131I-MIBG therapy for neuroendocrine tumours may be dose limited. The common range of applied cumulative activities is 10-40 GBq. We report the uneventful cumulative administration of 111 GBq (= 3 Ci) 131I-MIBG in a patient with metastatic paraganglioma. Ten courses of 131I-MIBG therapy were given within six years, accomplishing symptomatic, hormonal and tumour responses with no serious adverse effects. Chemotherapy with cisplatin/vinblastine/dacarbazine was the final treatment modality with temporary control of disease, but eventually the patient died of progression. The observed cumulative activity of 131I-MIBG represents the highest value reported to our knowledge, and even though 12.6 GBq of 90Y-DOTATOC were added intermediately, no associated relevant bone marrow, hepatic or other toxicity were observed. In an individual attempt to palliate metastatic disease high cumulative activity alone should not preclude the patient from repeat treatment.
131I-MIBG 疗法治疗神经内分泌肿瘤可能存在剂量限制。常用的累积应用活度范围为 10-40GBq。我们报告了一例转移性副神经节瘤患者成功接受 111GBq（=3Ci）131I-MIBG 累积给药，过程中无任何不良事件。在六年时间内进行了十次 131I-MIBG 治疗，实现了症状、激素和肿瘤的缓解，无严重不良反应。顺铂/长春碱/达卡巴嗪化疗是最终的治疗方式，暂时控制了疾病，但最终患者因疾病进展而死亡。观察到的 131I-MIBG 累积活度代表了我们所了解的最高值，尽管中间添加了 12.6GBq 的 90Y-DOTATOC，但未观察到相关的骨髓、肝脏或其他毒性。在缓解转移性疾病的个体尝试中，高累积活度本身不应阻止患者重复治疗。
