Management of neuroblastoma: Comparative study between first- and second-line radioionated metaiodobenzylguanidine therapy and chemotherapy alone

14^th World Cancer & Anti-Cancer Therapy Convention

November 21-23, 2016 Dubai, UAE

Khaled El Sabban and Hijji Al Sakhri

Cairo University, Egypt
Alhada Armed Force Hospital Taif, Saudi Arabia

Posters & Accepted Abstracts: J Cancer Sci Ther

Abstract :

Context: Neuroblastoma is a high-grade malignancy of childhood; it is chemo- and radio-sensitive, but prone to relapse after initial remission. Aim: The aim of this study was to document the impact of first- or second-line radioionated [131I] meta-iodobenzylguanidine (131I-MIBG) therapy or chemotherapy alone on the short-term response and long-term survival in untreated children and to further characterize the side-effects of MIBG treatment. Materials & Methods: In this interventional randomized controlled study, 123 children with advanced neuroblastoma were divided into 3 groups according to the treatment strategy: 65 were treated by chemotherapy alone (group I), 30 children who were not responding or had relapsed after chemotherapy were treated by second-line 131I-MIBG (group II), and 28 children were treated by 131I-MIBG as first-line from the start (group III). External beam radiotherapy was given to bone and brain secondaries when detected. Staging work up was done before, during, and after management with a follow-up period of 5 years. Results: The number of treatments with 131I-MIBG varied between 1 and 4 per patient (mean 3). Toxicity was seldom severe. Mainly myelosuppression was noticed. Response was documented before surgery for the primary tumor was performed. There were 9, 6 and 14 complete response (CR); 10, 18 and 16 partial responses (PR); 3, 2 and 23 with a stable disease (SD); and 6, 4 and 12 progressed in each group, respectively. Total actuarial survival was found to have a median of nearly 60, 55 and 33 months for groups I, II and III, respectively, with a statistical significant difference between the 3 groups. Conclusion: The current study showed the effectiveness of MIBG as a first-line treatment in the management of locally advanced neuroblastoma cases with limited metastasis as initial response and long-term survival for the cases was favorable, while in cases with multiple metastases, chemotherapy should be given first-line and, in case of failure or relapse, second-line MIBG therapy is warranted.

Biography :

Email: kelsaban@gmail.com