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Iodine-125-MIBG to Treat Neuroblastoma: Preliminary Report

Department of Internal Medicine, Division of Nuclear Medicine, Department of Pediatrics, Division of Hematology Oncology, University of Michigan Medical Center, Ann Arbor, Michigan

Correspondence: For reprints contact: James C. Sisson, MD, Department of Nuclear Medicine, B1G412 University Hospital, University of Michigan Medical Center, 1500 East Medical Center Dr., Ann Arbor, MI 48109-0028.

ABSTRACT

Three children with Stage III neuroblastoma were treated with [¹²⁵I]MIBG in a phase I toxicity study. Concepts of the treatment were: in small tumors, the absorbed dose of radiation from MIBG labeled with ¹³¹I is reduced but the absorbed dose from [¹²⁵I]MIBG is less affected; and many recurrences of neuroblastoma arise from small tumors. Two patients exhibited only modest thrombocytopenia and leukopenia, the most sensitive indices of radiation toxicity, after receiving 261 and 407 mCi, and 83 and 104 rad of whole-body radiation. One patient died of progressive neuroblastoma; the other two patients have stable disease over 30 mo after treatment. Per millicurie given, [¹²⁵I]MIBG imparts about one-fourth the radiation dose of [¹³¹I]MIBG to the whole body. Iodine-125-MIBG can be given in doses that impart over 100 rad of whole-body radiation and that exceed 400 mCi before toxicity becomes limiting, even in small children.

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