Pediatric 131I-MIBG Therapy for Neuroblastoma: Whole-Body 131I-MIBG Clearance, Radiation Doses to Patients, Family Caregivers, Medical Staff, and Radiation Safety Measures

Purpose I-131-metaiodobenzylguanidine (I-131-MIBG) has been used in the diagnosis and therapy of neuroblastoma in adult and pediatric patients for many years. In this study, we evaluated whole-body I-131-MIBG clearance and radiation doses received by patients, family caregivers, and medical staff to establish appropriate radiation safety measures to be used in therapy applications. Methods Research was focused on 23 children and adolescents with metastatic neuroblastoma, with ages ranging from 1.8 to 13 years, being treated with I-131-MIBG. Based on measured external dose rates from patients, dosimetric data to patients, family members, and others were calculated. Results The mean SD I-131-MIBG activity administered was 8.55 +/- 1.69 GBq. Percent whole-body retention rates of I-131-MIBG at 24, 48, and 72 hours after administration were 48% +/- 7%, 23% +/- 7%, and 12% +/- 6%, with a whole-body I-131-MIBG effective half-life of 23 +/- 5 hours for all patients. The mean doses for patients were 0.234 +/- 0.096 mGyMBq(-1) to red-marrow and 0.251 +/- 0.101 mGyMBq(-1) to whole body. The maximum potential radiation doses transmitted by patients to others at 1.0 m was estimated to be 11.9 +/- 3.4 mSv, with 97% of this dose occurring over 120 hours after therapy administration. Measured mean dose received by the 22 family caregivers was 1.88 +/- 1.85 mSv, and that received by the 19 pediatric physicians was 43 +/- 51 Sv. Conclusion In this study, we evaluated the whole-body clearance of I-131-MIBG in 23 pediatric patients, and the radiation doses received by family caregivers and medical staff during these therapy procedures, thus facilitating the establishment of radiation safety measures to be applied in pediatric therapy.

Palavras-chave

neuroblastoma, I-131-MIBG, therapy, radiation exposure, dosimetry

URI

https://observatorio.fm.usp.br/handle/OPI/28083

Referências

BOLSTER AA, 1995, BRIT J RADIOL, V68, P481, DOI 10.1259/0007-1285-68-809-481
Chu BP, 2016, PEDIATR BLOOD CANCER, V63, P801, DOI 10.1002/pbc.25892
Cougnenc O, 2017, RADIAT PROT DOSIM, V173, P395, DOI 10.1093/rpd/ncw030
FIELDING SL, 1991, EUR J NUCL MED, V18, P308, DOI 10.1007/BF02285457
Gains JE, 2015, PEDIATR BLOOD CANCER, V62, P235, DOI 10.1002/pbc.25250
Han S, 2017, CLIN NUCL MED, V42, P271, DOI 10.1097/RLU.0000000000001546
Hjornevik T, 2015, J NUCL MED RAD THER, V6, P1
HOEFNAGEL CA, 1987, J NUCL MED, V28, P308
International Commission on Radiological Protection, 2004, ICRP PUBL, V94
Markelewicz RJ, 2013, CLIN NUCL MED, V38, P604, DOI 10.1097/RLU.0b013e31829af3c8
Matthay KK, 2006, J CLIN ONCOL, V24, P500, DOI 10.1200/JCO.2005.03.6400
Minguez P, 2015, MED PHYS, V42, P3969, DOI 10.1118/1.4921807
Monsieurs M, 2002, EUR J NUCL MED MOL I, V29, P1581, DOI 10.1007/s00259-002-0973-4
Radiological Protection Institute of Ireland, 2009, 0901 RPII NUCL EN BO
Shulkin BL, 1998, J NUCL MED, V39, P679
Stabin MG, 2008, FUNDAMENTALS NUCL ME
Trieu M, 2016, PEDIATR BLOOD CANCER, V63, P436, DOI 10.1002/pbc.25816
Tristam M, 1996, J NUCL MED, V37, P1058
Wafelman AR, 1997, EUR J NUCL MED, V24, P544
Willegaignon J, 2006, HEALTH PHYS, V91, P119, DOI 10.1097/01.HP.0000202232.98823.87
Willegaignon J, 2006, HEALTH PHYS, V91, P123, DOI 10.1097/01.HP.0000206041.25242.c0
Willegaignon J, 2006, HEALTH PHYS, V91, P624, DOI 10.1097/01.HP.0000225467.10064.34

Coleções

Artigos e Materiais de Revistas Científicas - FM/MDR
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - LIM/43
Artigos e Materiais de Revistas Científicas - ODS/03

Página do item completo