Neuroblastoma Therapy Administration
- Refer to
Dose Estimation for the amount to give. Keep bone marrow radiation dose below 2 Gy.- I-131 MIBG is given iv in an inpatient basis. Infusion should be administered slowly in 2-3 h.
- If hypertension ensues during the infusion, give propranolol or angiotensin-converting enzyme inhibitors or fenoxibenzamine. Only if these drugs have no effect and according to patient condition give alternatively calcium channel blockers (e.g. sublingual nifedipine).
- Detail in written form radiation protection directions to patient.
The protocol agreed to by the Spanish Society of Pediatric Oncology (SEOP) in 1992 recommended the administration of 200 mCi (7.4 GBq) divided into two doses with an interval of 24 h between them. It is administered by continuous infusion, diluted in saline for 1-4 h, no longer being recommended as an increased proportion of free 131I by radiolysis in conjunction with time (62). This dose of 200 mCi was repeated 4 times with intervals of 4 weeks (7.4 GBq x 4).
Prior to the therapeutic administration of 131-I-MIBG uptake should be blocked thyroid administration from the previous 8-10 days to 12-15 days later with a saturated solution of potassium iodide, and as prevention of late onset hypothyroidism.
References:
Diez L, Mitjavila M, Tumores Neuroendocrinos: estudios con meta-yodo-bencil-guanidina, p: 549-561 in: Medicina Nuclear Aplicaciones Clínicas. Eds: I. Carrio - P. González. Editorial Masson, Barcelona España, 2003.
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