Effects and safety of 131I-metaiodobenzylguanidine (MIBG) radiotherapy in malignant neuroendocrine tumors: Results from a multicenter observational registry

Keiichiro Yoshinaga; Noboru Oriuchi; Hiroshi Wakabayashi; Yuuki Tomiyama; Megumi Jinguji; Tetsuya Higuchi; Daiki Kayano; Makoto Fukuoka; Anri Inaki; Ayane Toratani; Shozo Okamoto; Tohru Shiga; Yoichi M. Ito; Masatoyo Nakajo; Masayuki Nakajo; Seigo Kinuya

doi:10.1507/endocrj.EJ14-0211

ORIGINALS

Effects and safety of ¹³¹I-metaiodobenzylguanidine (MIBG) radiotherapy in malignant neuroendocrine tumors: Results from a multicenter observational registry

Keiichiro Yoshinaga, Noboru Oriuchi, Hiroshi Wakabayashi, Yuuki Tomiyama, Megumi Jinguji, Tetsuya Higuchi, Daiki Kayano, Makoto Fukuoka, Anri Inaki, Ayane Toratani, Shozo Okamoto, Tohru Shiga, Yoichi M. Ito, Masatoyo Nakajo, Masayuki Nakajo, Seigo Kinuya

Author information

Keiichiro Yoshinaga
Department of Molecular Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Noboru Oriuchi
Department of Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi City, Japan
Hiroshi Wakabayashi
Department of Biotracer Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
Yuuki Tomiyama
Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Megumi Jinguji
Department of Radiology, Kagoshima University, Graduate School of Medicine, Kagoshima, Japan
Tetsuya Higuchi
Department of Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi City, Japan
Daiki Kayano
Department of Biotracer Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
Makoto Fukuoka
Department of Biotracer Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
Anri Inaki
Department of Biotracer Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
Ayane Toratani
Department of Biotracer Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
Shozo Okamoto
Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Tohru Shiga
Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Yoichi M. Ito
Department of Clinical Statistics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Masatoyo Nakajo
Department of Radiology, Kagoshima University, Graduate School of Medicine, Kagoshima, Japan
Masayuki Nakajo
Department of Radiology, Kagoshima University, Graduate School of Medicine, Kagoshima, Japan
Seigo Kinuya
Department of Biotracer Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan

Keywords: ¹³¹I-MIBG, Neuroendocrine tumor, Radiotherapy, Malignant pheochromocytoma, Malignant paraganglioma

JOURNAL FREE ACCESS

2014 Volume 61 Issue 12 Pages 1171-1180

DOI https://doi.org/10.1507/endocrj.EJ14-0211

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Abstract

Effective treatments for malignant neuroendocrine tumors are under development. While iodine-131 metaiodobenzylguanidine (¹³¹I-MIBG) radiotherapy has been used in the treatment of malignant neuroendocrine tumors, there are few studies evaluating its therapeutic effects and safety in a multicenter cohort. In the current study, we sought to evaluate the effects and safety of ¹³¹I-MIBG therapy for conditions including malignant pheochromocytoma and paraganglioma within a multicenter cohort. Forty-eight malignant neuroendocrine tumors (37 pheochromocytoma and 11 paraganglioma) from four centers underwent clinical ¹³¹I-MIBG radiotherapy. The tumor responses were observed before and 3 to 6 months after the ¹³¹I-MIBG radiotherapy in accordance with RECIST criteria. We also evaluated the data for any adverse effects. The four centers performed a total of 87 ¹³¹I-MIBG treatments on 48 patients between January 2000 and March 2009. Of the treatments, 65 were evaluable using RECIST criteria. One partial response (PR), 40 stable disease (SD), and 9 progressive disease (PD) in malignant pheochromocytoma were observed after each treatment. Fourteen SD and one PD-were observed in paraganglioma. Patients with normal hypertension (systolic blood pressure (BP) > 130 mmHg) showed significantly reduced systolic BP after the initial follow-up (n=10, 138.1±8.2 to 129.5±13.5 mmHg, P=0.03). In adult neuroendocrine tumors with a treatment-basis analysis, there were side effects following 41 treatments (47.1%) and most of them (90.2%) were minor. In this multicenter registry, PR or SD was achieved in 84.6% of the treatment occasions in adult neuroendocrine tumors through ¹³¹I-MIBG radiotherapy. This indicated that most of the ¹³¹I-MIBG radiotherapy was performed safely without significant side effects.

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