Therapeutic use of 131-Iodine meta-Iodobenzylguanidine in neuroendocrine tumours – the development and evaluation of a new radiopharmaceutical service


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Emma Bates1, Jonathan Wadsley1, Sally Walton1, C Taylor1
1Weston Park Hospital, Sheffield, UK

Background

Radioiodine conjugated Meta-Iodobenzylguanidine (131I-MIBG) therapy is an established treatment option for patients with unresectable or metastatic neuroendocrine tumours. 131I-MIBG therapy offers effective palliation, and may induce tumour regression or disease stabilisation assessed on radiological or biochemical grounds. Addition of MIBG therapy to other standard treatments may confer improved survival 1.

Method

In 2009 a service was established to offer 131I-MIBG therapy locally within our Cancer Network, anticipating treatment of up to 12 patients per year from a population of approximately 100 new referrals to the Neuroendocrine Oncology MDT. We describe the initiation of the service, and present a recently updated audit examining the first three years of service delivery. Audit standards assessed included patient selection, pre-treatment investigation, safe delivery of therapy in accordance with best practice guidelines, administered dose, and documentation of symptomatic and radiological or biochemical response.

Results

Results have demonstrated good compliance with appropriate standards for the selection of patients, and the safe administration of 131 I-MIBG therapy within the service. Symptomatic and objective response rates were in keeping with those demonstrated in published literature. Treatment was well tolerated with no serious or unexpected adverse events.

Conclusion

Decentralisation of radiopharmaceutical therapy services provides practical benefits to patients. The establishment of new 131I-MIBG therapy services requires multidisciplinary team involvement in service development and delivery. New services can demonstrate safe and effective therapy in concordance with best practice guidelines and published experience.