Abstract
Introduction Neuroblastoma is the most common extracranial solid tumor in childhood. The data
on the treatment experience with 131iodine-meta-iodo-benzyl-guanidine (131I-mIBG) and clinical outcome data are meager from India.
Objectives This article studies the efficacy and treatment outcomes in patients treated with
131I-mIBG in high-risk neuroblastoma.
Materials and Methods The study group consisted of 201 consecutive patients (aged between 1 and 15 years)
with biopsy-proven neuroblastoma who underwent 131I-mIBG scans from 2012 to 2022. The majority of these children had a disease that
was inoperable or had poor response to chemotherapy. Patients with positive scintigraphy
were considered for therapy with 131I-mIBG. The findings were analyzed and correlated with the final diagnosis and outcomes
obtained from survival during follow-up and reviewing patient records.
Results Thirty-nine children, 22 males and 17 females, with a median age of 4 years had positive
131I-mIBG scintigraphy. Intra-abdominal primary lesions and osseous lesions were the
most common sites of uptake on 131I-mIBG scan. Of these, 13 had upfront chemotherapy and 26 had surgery followed by
chemotherapy. All the patients underwent therapy with 131I-mIBG. Fourteen patients had multiple therapies while the remaining 25 had only one
therapy. Eight patients had no follow-up, and 13 had disease relapse. The remaining
18 had regression of disease which was confirmed by follow-up 131I-mIBG scintigraphy and with bone scintigraphy in patients with osseous metastases.
Conclusion 131I-mIBG scintigraphy should be preferred in intermediate and high-risk neuroblastoma
to know the extent of the disease and also for patient selection for early therapy
with 131I-mIBG. It holds significant utility in the management of metastatic neuroblastoma,
facilitating palliative pain relief and tumor size reduction in inoperable or metastatic
disease.
Keywords
neuroblastoma -
131I-mIBG -
131I-mIBG therapy
