《131I标记间碘苄胍治疗神经母细胞瘤的疗效和安全性评价》.pdf.pdf

·262· 中国小儿血液与肿瘤杂志2010年12月第15卷第6期J China PediatrBloodCancer,December2010,Vol ·论著· 131I标记间碘苄胍治疗神经母细胞瘤的疗效和安全性评价陈阳黄东生郑宇张伟令李东伟刘海春【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”1I—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),”1I—MIBG 1850— 7400 MBq(50~200 mCi)溶于250 %***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”1I—MIBG 7400 MBq(200 mCi),均于用药20—30 d后突眼明显缓解,l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l例。结论 I—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。【关键词】闻碘苄胍;神经母细胞瘤; 疗效 Valuation ofclinicalefficacy and safety of131I-MIBG treatment inneuroblastoma(Attaching 5cases) Chen Yan91,Huang Dongshen92,Zheng Yul,Zhang Weilin92,Li Dongweil,Liu Hospital Affiliated toChina InstituteofAtomic Energy, Tongren Hospital, Beijing 100037,China 【Ahstract】Objective Toobserve chnicalreactionofmI-MIBG(131I-MIBG)therapy inneuroblastoma stageIV andevaluate efficacy Fiveneumblastoma stage IVpatients withpositive SPECT imaging were selected pound odine solution was used toclose—down the patient’Sthyroid 3—5 days before treatment untilthe7thday 850~7400 MBq(50— 200mCi)”1 I-MIBG dissolved in250ml %NaCI forintravenous symptom improvement aftertreatment was observed,including pain,fever,and proptosi