Experiences from Introducing Standardized High Dose 131I-mIBG Treatment of Children with Refractory Neuroblastoma: Differences in Effective Dose to Patients and Exposure to CaregiversTrine Hjornevik*, Anne Catrine Martinsen, Signe Elise Hagve, Merethe Wigen Andersen, Ann Cecilie Mørk, Jan Gunnar Fjeld and Ellen Ruud
The Intervention Centre, Oslo University Hospital, Oslo, Norway
- *Corresponding Author:
- Trine Hjørnevik
The Intervention Centre
Oslo University Hospital
P.O Box: 4950 Nydalen
Received date: September 14, 2015 Accepted date: October 14, 2015 Published date: October 19, 2015
Citation: Hjørnevik T, Martinsen AC, Hagve SE, Andersen MW, Mørk AC, et al. (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. J Nucl Med Radiat Ther 6:258. doi:10.4172/2155-9619.1000258
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
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.