摘要
目的观察131I标记间碘苄胍(131I-MIBG)在Ⅳ期神经母细胞瘤患儿应用过程中的临床反应,评价其有效性和安全性。方法选择131I-MIBG SPECT显像阳性的5例Ⅳ期神经母细胞瘤患儿为治疗组,用药前3~5 d常规应用复合碘溶液封闭甲状腺(至用药后7 d),131I-MIBG 1850~7400 MBq(50~200 mCi)溶于250 ml的0.9%氯化钠注射液中静脉滴注,用药后观察临床疼痛、发热、突眼等症状的改善情况,并对血液生化及影像学资料的变化进行比较,评价其有效性和安全性。结果 5例中3例转移性骨痛患儿用药24 h内疼痛消失,3例眼症患儿中有2例单次应用131I-MIBG7400 MBq(200 mCi),均于用药20~30 d后突眼明显缓解,1例患儿视力恢复;颅顶转移灶缩小>50%。毒副作用:骨髓抑制出现较高,肾上腺危象出现1例。结论 131I-MIBG对于Ⅳ期神经母细胞瘤患儿控制症状、延缓病情进展具有显著的治疗效果,但应注意毒副作用的发生,及时纠正。对于儿童剂量的确定,有待进一步探讨。
Objective To observe clinical reaction of 131I-MIBG（131I-MIBG） therapy in neuroblastoma stage Ⅳ and evaluate its efficacy and safety.Methods Five neuroblastoma stage IV patients with positive SPECT imaging were selected in this research.Compound odine solution was used to close-down the patient＇s thyroid 3~5 days before treatment until the 7th day after treatment.1850~7400 MBq（50~200 mCi）131I-MIBG dissolved in 250ml of 0.9% NaCl for intravenous drip.The symptom improvement after treatment was observed,including pain,fever,and proptosis.The changes of blood biochemistry and iconography were evaluated.Results All 3 cases with metastatic bone pain relieved within 24 hours.Two cases with proptosis who received single dose 200 mCi 131I-MIBG obviously improved in 20~30 days after therapy;one case regained the vision.Parietal metastasis reduced 50%.However,myelosuppression was observed in more cases,and one case appeared adrenal crisis.Conclusion 131I-MIBG is an efficient therapy for neuroblastoma Ⅳ patient in improving symptoms and delaying progression of disease.Side-effects should be paid attention to and treated immediately.The dose of 131I-MIBG therapy applicable for pediatrics need further investigation.
出处
《中国小儿血液与肿瘤杂志》
CAS
2010年第6期262-264,共3页
Journal of China Pediatric Blood and Cancer
关键词
间碘苄胍
神经母细胞瘤
疗效
Metaiodobenzylguandine
neuroblastoma
treatment efficacy
