Therapeutic nuclear medicine in pediatric malignancy

Area of Science:

• Nuclear Medicine
• Pediatric Oncology
• Radiopharmaceutical Therapy

Background:

• Paediatric malignancies are rare but diverse, requiring specialized treatment approaches.
• Therapeutic nuclear medicine offers targeted treatment options for various childhood cancers.
• Established and emerging radiopharmaceutical therapies are crucial for improving outcomes.

Purpose of the Study:

• To provide a contemporary overview of therapeutic nuclear medicine procedures in paediatric malignancies.
• To highlight the role of specific radiopharmaceuticals in treating neuroblastoma, neuroendocrine tumors, osteosarcoma, and thyroid cancer.
• To discuss current advancements and future directions in pediatric nuclear medicine oncology.

Main Methods:

• Review of existing literature and clinical experience with therapeutic nuclear medicine in children.
• Focus on radiopharmaceuticals such as I-131-mIBG, radiolabeled somatostatin analogues, bone-seeking radionuclides, and radioiodine.
• Discussion of patient selection, dosimetry, and treatment strategies.

Main Results:

• I-131-mIBG has a 30-year history for neuroblastoma treatment, with ongoing standardization efforts.
• Peptide receptor radionuclide therapy is utilized for rare paediatric neuroendocrine tumors.
• Bone-seeking radionuclides offer palliative care for metastatic osteosarcoma.
• Radioiodine therapy is a key treatment for childhood thyroid cancer, with unique protocols.

Conclusions:

• Therapeutic nuclear medicine provides vital, targeted treatment options for several paediatric cancers.
• Continued research and standardization are essential for optimizing radiopharmaceutical therapies in children.
• Personalized approaches, including dosimetry, are crucial for effective treatment delivery.