Sisson J C, Shapiro B, Hutchinson R J, Carey J E, Zasadny K R, Zempel S A, Normolle D P
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0028.
Eur J Nucl Med. 1994 Jan;21(1):46-52. doi: 10.1007/BF00182305.
We searched for methods that would enable prescriptions of the maximum tolerable doses of iodine-131 metaiodobenzylguanidine (MIBG) and iodine-125 MIBG in the treatment of patients with neuroblastoma. We correlated doses, defined in different ways, with subsequent platelet levels in treated patients to determine accurate predictors of the most frequent toxicity, thrombocytopenia. Nine patients with neuroblastoma were given 131I-MIBG (4.9-8.1 GBq or 132-220 mCi) and ten were given 125I-MIBG (8.3-30.0 GBq or 224-809 mCi) as initial treatments. These therapies were sufficiently varied that correlations could be made between indices of the doses and the subsequent toxicity as reflected in circulating platelet levels. Predictors of toxicity were: whole-body absorbed dose of radiation (cGy) calculated from pretherapy tracer doses of 131I-MIBG; GBq/kg of body weight; and GBq/m2 of body surface area. Toxicity was recorded as the nadir of the platelet level and platelet/pretherapeutic level (platelet ratio). For treatments with 131I-MIBG, the highest correlation was obtained between cGy and the log10-transformed platelet ratio (r = -0.86), but comparison of GBq/m2 and the platelet nadir (r = -0.76) or the platelet ratio (r = -0.74) or the log10 transformed platelet ratio (r = -0.73) gave comparable and statistically significant results. For treatments with 125I-MIBG, significant correlations were obtained between GBq/m2 and the platelet ratio (r = -0.81) or GBq/kg and the log10-transformed platelet ratio; the correlation between cGy and any toxicity index was low. Per administered GBq, 131I-MIBG was 2.6 times more potent than 125I-MIBG in causing a platelet ratio of 0.1.(ABSTRACT TRUNCATED AT 250 WORDS)
我们探寻了能够确定神经母细胞瘤患者治疗中碘-131间碘苄胍（MIBG）和碘-125 MIBG最大耐受剂量的方法。我们将以不同方式定义的剂量与接受治疗患者随后的血小板水平相关联，以确定最常见毒性即血小板减少症的准确预测指标。9例神经母细胞瘤患者接受了131I-MIBG（4.9 - 8.1 GBq或132 - 220 mCi）作为初始治疗，10例患者接受了125I-MIBG（8.3 - 30.0 GBq或224 - 809 mCi）作为初始治疗。这些治疗差异足够大，以至于可以在剂量指标与循环血小板水平所反映的后续毒性之间建立相关性。毒性预测指标为：根据治疗前131I-MIBG示踪剂剂量计算的全身辐射吸收剂量（cGy）；每千克体重的GBq数；以及每平方米体表面积的GBq数。毒性记录为血小板水平最低点以及血小板/治疗前水平（血小板比率）。对于131I-MIBG治疗，cGy与经对数10转换的血小板比率之间相关性最高（r = -0.86），但每平方米GBq数与血小板最低点（r = -0.76）或血小板比率（r = -0.74）或经对数10转换的血小板比率（r = -0.73）的比较给出了相当且具有统计学意义的结果。对于125I-MIBG治疗，每平方米GBq数与血小板比率（r = -0.81）或每千克GBq数与经对数10转换的血小板比率之间存在显著相关性；cGy与任何毒性指标之间的相关性较低。每给予1 GBq，131I-MIBG导致血小板比率为0.1的效力比125I-MIBG高2.6倍。（摘要截取自250字）
