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Experiences from Introducing Standardized High Dose 131I-mIBG Treatment of Children with Refractory Neuroblastoma: Differences in Effective Dose to Patients and Exposure to Caregivers

Hjornevik, Trine; Martinsen, Anne Catrine; Hagve, Signe Elise; Andersen, Merethe Wigen; Mørk, Ann Cecillie; Fjeld, Jan Gunnar; Ruud, Ellen
Journal article, Peer reviewed
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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URI
http://dx.doi.org/10.4172/2155-9619.1000258
https://hdl.handle.net/10642/3254
Date
2015-10-19
Metadata
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  • HV - Institutt for naturvitenskapelige helsefag [361]
Original version
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.
Publisher
OMICS International
Series
Journal of Nuclear Medicine & Radiation Therapy;6(6)

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