Background. Despite of improving diagnostics, development of new drugs and treatmen strategies, pa tients with
biologically unfavourable, advanced or relapsed neuroblastoma remain practically incurable. Treatment related
toxicity, requirement for personnel and financial costs have became limiting. Tumor specific therapy represented
I-meta-iodobenzylguanidine (MIBG) administration could become an alternative improving the overall
survival. In comparison with standard external radiotherapy the targeted therapy enables to achieve radiation 5 to
10 times higher with lower organ toxicity. Data published by European and American colleagues brought evidence
of high efficacy of this method. It motivated us to set and develop the method at our department.
Type of Study. Retrospective analysis of therapeutic results and side effects of the administration of
-iodobenzylguanidine in high-risk neuroblastoma patients cured at the Department of Pediatric Oncology in Prague
since 1997 till 2000.
Method and Results.
I-meta-iodobenzylguanidine was fourteen times therapeutically administered in seven
high-risk relapsed neuroblastoma patients. Four children received a single dose of
three patients were treated repeatedly. The first dose represented 5,5 GBq, repeated dose 3,7 GBq, irrespective to
the body weight. Each MIBG administration was followed by four days hyperbaric oxygen therapy. The treatment
was well tolerated, acute and late side effects were not serious and only rarely reached grade 3 or 4 according to the
International North American Children’s Cancer Group Classification. Three of the seven children have survived
with no evidence of the disease. Four children died of the disease progress.
I-meta-iodobenzylguanidine treatment combined with hyperbaric oxygen therapy becomes a well-
tolerated therapy for high-risk neuroblastoma patients non-responding to the conventional treatment. Though the
I-meta-iodobenzylguanidine administration probably cannot cure these patients, the repeated administration can
bring long lasting remission.
I MIBG, targeted radiotherapy, hyperbaric oxygen therapy, therapy.