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Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
Peer-reviewed Journal Articles, etc >
Effects of Repeated I-131-Meta-Iodobenzylguanidine Radiotherapy on Tumor Size and Tumor Metabolic Activity in Patients with Metastatic Neuroendocrine Tumors
| Title: | Effects of Repeated I-131-Meta-Iodobenzylguanidine Radiotherapy on Tumor Size and Tumor Metabolic Activity in Patients with Metastatic Neuroendocrine Tumors |
| Authors: | Yoshinaga, Keiichiro Browse this author | | Abe, Takashige Browse this author →KAKEN DB | | Okamoto, Shozo Browse this author →KAKEN DB | | Uchiyama, Yuko Browse this author | | Manabe, Osamu Browse this author | | Ito, Yoichi M. Browse this author →KAKEN DB | | Tamura, Naomi Browse this author →KAKEN DB | | Ito, Natsue Browse this author | | Yoshioka, Naho Browse this author | | Washino, Komei Browse this author | | Shinohara, Nobuo Browse this author →KAKEN DB | | Tamaki, Nagara Browse this author | | Shiga, Tohru Browse this author →KAKEN DB |
| Keywords: | I-131-MIBG | | F-18-FDG PET | | metastasis | | neuroendocrine tumor | | radiotherapy | | RECIST |
| Issue Date: | 10-May-2021 |
| Publisher: | Society of Nuclear Medicine |
| Journal Title: | Journal of nuclear medicine |
| Volume: | 62 |
| Issue: | 5 |
| Start Page: | 685 |
| End Page: | 694 |
| Publisher DOI: | 10.2967/jnumed.120.250803 |
| Abstract: | I-131-meta-iodobenzylguanidine (I-131-MIBG) radiotherapy has shown some survival benefits in metastatic neuroendocrine tumors (NETs). European Association of Nuclear Medicine clinical guidelines for I-131-MIBG radiotherapy suggest a repeated treatment protocol, although none currently exists. The existing single-high-dose I-131-MIBG radiotherapy (444 MBq/kg) has been shown to have some benefits for patients with metastatic NETs. However, this protocol increases adverse effects and requires alternative therapeutic approaches. Therefore, the aim of this study was to evaluate the effects of repeated I-131-MIBG therapy on tumor size and tumor metabolic response in patients with metastatic NETs. Methods: Eleven patients with metastatic NETs (aged 49.2 +/- 16.3 y) prospectively received repeated 5,550-MBq doses of I-131-MIBG therapy at 6-mo intervals. In total, 31 treatments were performed. The mean number of treatments was 2.8 0.4, and the cumulative I-131-MIBG dose was 15,640.9 + 2,245.1 MBq (286.01 MBq/kg). Tumor response was observed by CT and 18F-FDG PET or by F-18-FDG PET/CT before and 3-6 mo after the final I-131-MIBG treatment. Results: On the basis of the CT findings with RECIST, 3 pa tients showed a partial response and 6 patients showed stable disease. The remaining 2 patients showed progressive disease. Al though there were 2 progressive-disease patients, analysis of all patients showed no increase in summed length diameter (median, 228.7 mm [interquartile range (10R), 37.0-336.0 mm] to 171.0 mm [IQR, 38.0-270.0 mm]; P = 0.563). In tumor region-based analysis with par tial-response and stable-disease patients (n = 9), I-131-MIBG therapy significantly reduced tumor diameter (79 lesions; median, 16 mm [IQR, 12-22 mm] to 11 mm [10R, 6-16 mm]; P < 0.001). Among 5 patients with hypertension, there was a strong trend toward systolic blood pressure reduction (P = 0.058), and diastolic blood pressure was significantly reduced (P = 0.006). Conclusion: Eighty-two percent of metastatic NET patients effectively achieved inhibition of disease progression, with reduced tumor size and reduced metabolic activity, through repeated I-131-MIBG therapy. Therefore, this relatively short-term repeated I-131-MIBG treatment may have potential as one option in the therapeutic protocol for metastatic NETs. Larger prospective studies with control groups are warranted. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/85589 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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