Treuner J, Klingebiel T, Feine U, Buck J, Bruchelt G, Dopfer R, Girgert R, Müller-Schauenburg W, Meinke J, Kaiser W
Department of Hematology and Oncology, Pediatric University Hospital, Tübingen, West Germany.
Pediatr Hematol Oncol. 1986;3(3):205-16. doi: 10.3109/08880018609031220.
Treatment of neuroblastoma is an unsolved problem of pediatric oncology. In spite of highly intensified chemotherapy, the long-term survival rate of children with a metastatic neuroblastoma is below 10%. We therefore used 131I-metaiodobenzylguanidine (MIBG) for the first time to treat children with a neuroblastoma in relapse or primary unresponsiveness to chemotherapy. We had previously demonstrated that MIBG is useful for the scintigraphic imaging of neuroblastoma lesions and had investigated the cytotoxicity and uptake of MIBG in various neuroblastoma cell lines. We treated 6 children with neuroblastoma in a total of 19 courses. Three of the children suffered from a relapse of neuroblastoma; 3 had never gained a remission. Four of the 6 children lost their bone pain and fever during the first 3 days. In 5 of the 6 children the solid tumor as well as the bone marrow infiltration responded to MIBG treatment, with responses ranging from transitory decrease of the tumor mass to complete disappearance of abdominal tumors. We also witnessed a stabilization of osteolytic lesions, a decrease in elevated serum catecholamines, and a decrease in bone marrow infiltration. Five of the 6 children died of tumor progression 55-249 days after the first MIBG treatment.
神经母细胞瘤的治疗是儿科肿瘤学中一个尚未解决的问题。尽管采用了高强度化疗，但转移性神经母细胞瘤患儿的长期生存率仍低于10%。因此，我们首次使用131I-间碘苄胍（MIBG）治疗复发或对化疗原发性无反应的神经母细胞瘤患儿。我们之前已经证明MIBG可用于神经母细胞瘤病变的闪烁显像，并研究了MIBG在各种神经母细胞瘤细胞系中的细胞毒性和摄取情况。我们共对6名神经母细胞瘤患儿进行了19个疗程的治疗。其中3名患儿神经母细胞瘤复发；3名患儿从未缓解。6名患儿中有4名在最初3天内骨痛和发热症状消失。6名患儿中有5名的实体瘤以及骨髓浸润对MIBG治疗有反应，反应程度从肿瘤肿块暂时缩小到腹部肿瘤完全消失不等。我们还观察到溶骨性病变稳定、血清儿茶酚胺水平降低以及骨髓浸润减少。6名患儿中有5名在首次MIBG治疗后55 - 249天死于肿瘤进展。
