Vol 69, No 3 (2018)
Original paper
Published online: 2018-04-12

open access

Page views 4051
Article views/downloads 2744
Get Citation

Connect on Social Media

Connect on Social Media

131-I MIBG therapy of malignant pheochromocytoma and paraganglioma tumours — a single-centre study

Agnieszka Kotecka-Blicharz1, Kornelia Hasse-Lazar1, Daria Handkiewicz-Junak1, Tomasz Gawlik1, Agnieszka Pawlaczek1, Małgorzata Oczko-Wojciechowska1, Barbara Michalik1, Sylwia Szpak-Ulczok1, Jolanta Krajewska1, Beata Jurecka-Lubieniecka1, Barbara Jarząb1
Pubmed: 29645065
Endokrynol Pol 2018;69(3):246-251.


Introduction: Pheochromocytomas and paragangliomas are rare tumors deriving from chromaffin cells of adrenal medulla or paraganglia. They are usually benign but 10-35% of them present malignant behavior. The aim of the study was to evaluate the efficacy and safety of 131-I MIBG therapy in malignant pheochromocytoma /paraganglioma patients (MPPGL). Material and methods: 18 patients (7 women and 11 men) were included in this study. Between 2002 and 2016 they underwent 131-I MIBG therapy because of MPPGL and their medical data were analyzed retrospectively. Clinical indications for the treatment included progressive disease or massive tissue involvement independently from disease progression. Tumor response for the first time was assessed 3 months after the last treatment according to Response Evaluation Criteria in Solid Tumors criteria and by 131-I MIBG scans. Results: The mean single dose used was 7.25 GBq (196 mCi) and mean cumulative dose 33.08 GBq ( 894 mCi). In 2 (11%) patients complete tumor response was achieved. In 1 (6%) patient partial response was obtained. In 13 (72%) patients stable disease was observed. In 2 (11%) patients progression was diagnosed three months after treatment discontinuation. In the whole studied group the progression free survival time was 85 months and overall 5-year survival was 87%. Conclusions: Radionuclide treatment with use of 131-I MIBG may be effective form of palliative treatment for patients with inoperative neoplasm spread, progressive disease or patients requiring alleviation of symptoms. < p > < /p >

Article available in PDF format

View PDF Download PDF file


  1. Lenders JWM, Duh QY, Eisenhofer G, et al. Endocrine Society. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014; 99(6): 1915–1942.
  2. Harari A, Inabnet WB. Malignant pheochromocytoma: a review. Am J Surg. 2011; 201(5): 700–708.
  3. Därr R, Lenders JWM, Hofbauer LC, et al. Pheochromocytoma - update on disease management. Ther Adv Endocrinol Metab. 2012; 3(1): 11–26.
  4. Martucci VL, Pacak K. Pheochromocytoma and paraganglioma: diagnosis, genetics, management, and treatment. Curr Probl Cancer. 2014; 38(1): 7–41.
  5. Lowery AJ, Walsh S, McDermott EW, et al. Molecular and therapeutic advances in the diagnosis and management of malignant pheochromocytomas and paragangliomas. Oncologist. 2013; 18(4): 391–407.
  6. Gonias S, Goldsby R, Matthay KK, et al. Phase II study of high-dose [131I]metaiodobenzylguanidine therapy for patients with metastatic pheochromocytoma and paraganglioma. J Clin Oncol. 2009; 27(25): 4162–4168.
  7. Adjallé R, Plouin PF, Pacak K, et al. Treatment of malignant pheochromocytoma. Horm Metab Res. 2009; 41(9): 687–696.
  8. Andersen KF, Altaf R, Krarup-Hansen A, et al. Malignant pheochromocytomas and paragangliomas - the importance of a multidisciplinary approach. Cancer Treat Rev. 2011; 37(2): 111–119.
  9. Shapiro B, Sisson JC, Wieland DM, et al. Radiopharmaceutical treatment of malignant pheochromocytoma. J Nucl Med. 1984; 25(2): 197–206.
  10. Charbonnel B, Chatal JF, Brendel AJ, et al. [Treatment of malignant pheochromocytoma by 131-I-metaiodobenzylguanidine]. Ann Endocrinol (Paris). 1988; 49(4-5): 344–347.
  11. Krempf M, Lumbroso J, Mornex R, et al. Use of m-[131I]iodobenzylguanidine in the treatment of malignant pheochromocytoma. J Clin Endocrinol Metab. 1991; 72(2): 455–461.
  12. Schlumberger M, Gicquel C, Lumbroso J, et al. Malignant pheochromocytoma: clinical, biological, histologic and therapeutic data in a series of 20 patients with distant metastases. J Endocrinol Invest. 1992; 15(9): 631–642.
  13. Sakahara H, Endo K, Saga T, et al. 131I-metaiodobenzylguanidine therapy for malignant pheochromocytoma. Annals of Nuclear Medicine. 1994; 8(2): 133–137.
  14. Safford SD, Coleman RE, Gockerman JP, et al. Iodine -131 metaiodobenzylguanidine is an effective treatment for malignant pheochromocytoma and paraganglioma. Surgery. 2003; 134(6): 956–62; discussion 962.
  15. Gedik GK, Hoefnagel CA, Bais E, et al. 131I-MIBG therapy in metastatic phaeochromocytoma and paraganglioma. Eur J Nucl Med Mol Imaging. 2008; 35(4): 725–733.
  16. Castellani MR, Seghezzi S, Chiesa C, et al. (131)I-MIBG treatment of pheochromocytoma: low versus intermediate activity regimens of therapy. Q J Nucl Med Mol Imaging. 2010; 54(1): 100–113.
  17. Shilkrut M, Bar-Deroma R, Bar-Sela G, et al. Low-dose iodine-131 metaiodobenzylguanidine therapy for patients with malignant pheochromocytoma and paraganglioma: single center experience. Am J Clin Oncol. 2010; 33(1): 79–82.
  18. Loh KC, Fitzgerald PA, Matthay KK, et al. The treatment of malignant pheochromocytoma with iodine-131 metaiodobenzylguanidine (131I-MIBG): a comprehensive review of 116 reported patients. J Endocrinol Invest. 1997; 20(11): 648–658.
  19. Brans B, Monsieurs M, Laureys G, et al. Thyroidal uptake and radiation dose after repetitive I-131-MIBG treatments: influence of potassium iodide for thyroid blocking. Med Pediatr Oncol. 2002; 38(1): 41–46.
  20. Rutherford MA, Rankin AJ, Yates TM, et al. Management of metastatic phaeochromocytoma and paraganglioma: use of iodine-131-meta-iodobenzylguanidine therapy in a tertiary referral centre. QJM. 2015; 108(5): 361–368.
  21. Samaan NA, Hickey RC, Shutts PE. Diagnosis, localization, and management of pheochromocytoma. Pitfalls and follow-up in 41 patients. Cancer. 1988; 62(11): 2451–2460.
  22. Wakabayashi H, Taki J, Inaki A, et al. Prognostic values of initial responses to low-dose (131)I-MIBG therapy in patients with malignant pheochromocytoma and paraganglioma. Ann Nucl Med. 2013; 27(9): 839–846.