TRATTAMENTO CON 131-I METAIODOBENZILGUANIDINA IN BAMBINI AFFETTI DA NEUROBLASTOMA

This study reports our experience in metabolic radiotherapy in 54 children with advanced neuroblastoma treated between 1986 and 1992 with 131-I-metaiodobenzylguanidine (131-I MIBG). One child was treated at diagnosis, 8 for a primary tumor inoperable after chemotherapy, 20 children had been resistant to first line therapy, 4 had suffered a local relapse, 4 a disseminated relapse and 17 had suffered a disseminated relapse without overt bone infiltration. One child was treated initially because of resistance to first-line therapy, and subsequently for a local relapse. A total of 125 courses of 131-I MIBG was administered, with doses ranging from 2.6 to 6.0 GBq (median 3.7 GBq). One child received five courses, 3 four courses, 21 three courses, 13 two courses and 16 one course of 131-I MIBG. The most common toxic effect was thrombocytopenia. Seven children presented a reduced thyroideal function and 5 are presently receiving thyroxine. There were 9 major responses (two complete), and 7 minor responses. Responses were seen more commonly in children whose only lesion was a residual primary tumor and in children who had not been pretreated by chemotherapy where experienced disseminated relapse.