Experiences from Introducing Standardized High Dose 131I-mIBG Treatment of Children with Refractory Neuroblastoma: Differences in Effective Dose to Patients and Exposure to Caregivers
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Copyright: © 2015 hjørnevik t, et al. this is an open-access article distributed under the terms of the creative commons attribution license; which permits unrestricted use; distribution; and reproduction in any medium; provided the original author and source are credited.
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2015-10-19Metadata
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Hjornevik, T., Martinsen, A. C., Hagve, S. E., Andersen, M. W., Mørk, A. C., Fjeld, J. G., & Ruud, E. (2015). Experiences from Introducing Standardized High Dose 131I-mIBG Treatment of Children with Refractory Neuroblastoma: Differences in Effective Dose to Patients and Exposure to Caregivers. Journal of Nuclear Medicine & Radiation Therapy, 6(6), 1.Abstract
Aims: High dose 131I-meta iodobenzylguanidine (131I-mIBG) combined with radiosensitizing topotecan and
peripheral blood stem cell support is a promising treatment regimen for children with neuroblastoma (NB). Here we
present our first experiences, with particular focus on in vivo whole-body dosimetry and radiation exposure to family
caregivers and hospital staff.
Methods: Five children with relapsed or refractory NB were treated during 2012-2014. 131I-mIBG was
administered in two fractions at two weeks apart, aiming for a total whole-body radiation-absorbed dose of 4 Gy. The
131I-mIBG activity for the 2nd administration was calculated on the basis of the measured whole-body dose following
the 1st administration. Patients were isolated in a lead-shielded room, and all caregivers and staff received radiation
safety training, and carried an electronic personal dosimeter.
Results: The total administered activity ranged from 5.1 to 28.6 GBq (median: 22.9 GBq), resulting in effective
whole-body doses ranging from 2.1 to 4.3 Gy (median: 3.8 Gy). Two out of five patients deviated from the
anticipated dose exposure defined by the treatment protocol; one patient received 4.3 Gy after a single
administration, and for one patient the total whole-body dose was lower than anticipated (2.1 Gy). Radiation dose to
family caregivers ranged from 0.1 to 8.0 mSv. For staff members, the overall radiation dose was low, and provided
no concern regarding personal dosimetry.
Conclusion: High-dose 131I-mIBG treatment of children with NB has been successfully established at our
institution. Radiation doses to caregivers and hospital staff are acceptable and in compliance with national and
international guidelines. Two out of five patients deviated from the anticipated dose exposure, hence, accurate
dosimetry-guidance during administration of high dose 131I-mIBG treatment is necessary.