High-dose 131I-mIBG as consolidation therapy in pediatric patients with relapsed neuroblastoma and ganglioneuroblastoma: the Japanese experience

Ann Nucl Med. 2020 Nov;34(11):840-846. doi: 10.1007/s12149-020-01514-2. Epub 2020 Aug 29.

Abstract

Objective: Children with relapsed neuroblastoma have a poor prognosis despite modern multimodality therapy. Novel and more effective therapeutic strategies are required for relapsed neuroblastoma. We retrospectively examined the utility of consolidation therapy with high-dose 131I-meta-iodo-benzyl-guanidine (131I-mIBG) in relapsed neuroblastoma or ganglioneuroblastoma patients with complete response (CR) to induction therapy as demonstrated by diagnostic 123I-mIBG scintigraphy.

Methods: Between December 2009 and 2014, five patients with relapsed neuroblastoma and one with relapsed ganglioneuroblastoma received high-dose 131I-mIBG therapy. Overall and progression-free survival rates at five years after 131I-mIBG therapy were analyzed by the Kaplan-Meier method.

Results: During follow-up, three children showed no signs of disease relapse, whereas three died. One child without a relapse died from post-transplant side effects, and two children with a relapse died owing to tumor progression. The 5-year progression-free and overall survival rates after 131I-mIBG therapy were 44% and 67%, respectively.

Conclusions: Consolidation therapy with high-dose 131I-mIBG for patients with 2nd CR showed good overall and progression-free survival. While the risks of radiation exposure must be considered, high-dose 131I-mIBG therapy as consolidation therapy needs to be further investigated.

Keywords: Consolidation therapy; High-dose 131I-mIBG therapy; Relapsed neuroblastoma.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Consolidation Chemotherapy*
  • Female
  • Ganglioneuroblastoma / radiotherapy*
  • Humans
  • Infant
  • Japan
  • Male
  • Neuroblastoma / radiotherapy*
  • Radiation Dosage*
  • Radiotherapy Dosage
  • Recurrence
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome