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Published on: March 6, 2012
Sequelae and survivorship in patients treated with (131)I-MIBG therapy
W C C Sze1, A B Grossman, I Goddard
1Department of Endocrinology, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK.
Background:
(131)I-meta-iodobenzylguanidine ((131)I-MIBG) has been in therapeutic use since 1980s. Newer treatment modalities are emerging for neuroendocrine tumours (NETs) and chromaffin cell tumours (CCTs), but many of these do not yet have adequate long-term follow-up to determine their longer term efficacy and sequelae.
Methods:
Fifty-eight patients with metastatic NETs and CCTs who had received (131)I-MIBG therapy between 2000 and 2011 were analysed. Survival and any long-term haematological or renal sequelae were investigated.
Results:
In the NET group, the overall median survival and median survival following the diagnosis of metastatic disease was 124 months. The median survival following the commencement of (131)I-MIBG was 66 months. For the CCT group, median survival had not been reached. The 5-year survival from diagnosis and following the diagnosis of metastatic disease was 67% and 67.5% for NETs and CCTs, respectively. The 5-year survival following the commencement of (131)I-MIBG therapy was 68%. Thirty-two patients had long-term haematological sequelae: 5 of these 32 patients developed haematological malignancies. Two patients developed a mild deterioration in renal function.
Conclusion:
Long follow up of (131)I-MIBG therapy reveals a noteable rate of bone marrow toxicities and malignancy and long term review of all patients receiving radionuclide therapies is recommended.
Insights
Long-term (131)I-MIBG therapy for neuroendocrine and chromaffin cell tumors shows significant survival benefits but also notable rates of bone marrow toxicities and secondary malignancies. Continued patient review is essential.
Area of Science:
- Nuclear Medicine
- Oncology
- Radiopharmaceutical Therapy
Background:
- (131)I-meta-iodobenzylguanidine ((131)I-MIBG) has been a therapeutic option for neuroendocrine tumors (NETs) and chromaffin cell tumors (CCTs) since the 1980s.
- Emerging treatments for NETs and CCTs often lack long-term efficacy and sequelae data.
- This study evaluates the long-term outcomes of (131)I-MIBG therapy in these patient populations.
Purpose of the Study:
- To assess the long-term survival and sequelae of (131)I-MIBG therapy in patients with metastatic NETs and CCTs.
- To investigate the incidence of long-term hematological and renal toxicities associated with this treatment.
- To provide data supporting the continued use and monitoring of radionuclide therapies.
Main Methods:
- Retrospective analysis of 58 patients with metastatic NETs and CCTs treated with (131)I-MIBG between 2000 and 2011.
- Evaluation of survival data, including overall survival and survival post-metastasis diagnosis and post-therapy initiation.
- Assessment of long-term hematological and renal sequelae.
Main Results:
- Median survival for NETs was 124 months overall and 66 months post-(131)I-MIBG initiation. Median survival for CCTs was not reached.
- 5-year survival rates were 67-68% across different metrics for both NETs and CCTs.
- Long-term hematological sequelae occurred in 32 patients, with 5 developing malignancies. Two patients had mild renal function deterioration.
Conclusions:
- Long-term follow-up of (131)I-MIBG therapy highlights a significant rate of bone marrow toxicities and secondary malignancies.
- Radionuclide therapies require long-term patient review to monitor for delayed adverse effects.
- The study underscores the importance of comprehensive long-term surveillance for patients undergoing (131)I-MIBG treatment.
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