Journal
CANCER
Volume 98, Issue 2, Pages 389-396Publisher
JOHN WILEY & SONS INC
DOI: 10.1002/cncr.11523
Keywords
thyroid gland; hypothyroidism; radiation damage; 3-iodobenzylguanidine; neuroblastoma; radiation protection
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BACKGROUND. During radiolabeled metaiodobenzylguanidine (MIBG) administration in children with neuroblastoma, the thyroid is protected from I-123/131 uptake by potassium iodide. Despite this protection, up to 64% of patients develop thyroid dysfunction. The authors introduce a new method of radiation protection for the thyroid gland. METHODS. in a prospective cohort study, 34 children with neuroblastoma who received MIBG were given thyroxine, methimazole, and potassium iodide for protection of the thyroid gland. Protection started 1 day before the start of diagnostic I-123-MIBG and was continued until 4 weeks after the last therapeutic I-131-MIBG dose. Follow-up measurements were performed every 3 months after the protection was stopped. Visualization of the thyroid on MIBG images was reviewed by three nuclear medicine physicians. Results were compared with a historic control group of children who had received potassium iodide for thyroid protection during MIBG administration. RESULTS. After a mean follow-tip of 19 months, there were 23 evaluable patients. Thyroid function was normal in 86% of survivors compared with 44% of children in the historic control group (P = 0.011; Pearson chi-square test). Scintigraphic visualization of the thyroid diminished substantially after the new protection (21.5% vs. 5.3%, respectively; P = 0.000). CONCLUSIONS. The results of the current study indicate that compared with potassium iodide alone, combined thyroxine, methimazole, and potassium iodide protect the thyroid more effectively against radiation damage from I-123/131 during diagnostic and therapeutic MIBG administration in children with neuroblastoma. (C) 2003 American Cancer Society.
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