engleski

I-131 MIBG Therapy in Disseminated Medullary Thyroid Carcinoma

Background: Medullary thyroid carcinoma (MTC) is a form of thyroid carcinoma which originates from parafollicular C cells which produce calcitonin (hCt), and makes up 3-5% of all thyroid malignancies. Surgery is the most effective therapy, but treatment of metastatic carcinomas is still unsatisfactory. Methods: We overviewed relevant history, clinical findings, laboratory, imaging evaluation and management in 5 female patients with metastatic MTC (aged 15, 64, 70 and 74 years). After total thyroidectomy, the patients received therapy with 100 mCi 131I-MIBG in our Centre. Three of those patients received the therapy twice, second one 3 months up to 1 year after the first cycle, one underwent the therapy three times. All patients had widespread disease with neck recurrences (all 5 cases), liver and bone metastases (2/3 cases) and lung metastases (2 cases). After therapy, whole body scintigraphy was performed ; tumor marker levels (hCt, carcinoembryonic antigen (CEA), neuron specific enolase (NSE), chromogranin A (CgA), pro- gastrin releasing peptide (pro-GRP)) were measured before and after therapy. Results: In two patients we observed a slight decrease in hCt level after first MIBG therapy, in another one a slight decrease in CEA serum level, and no lung metastases were visible on whole body scan after second MIBG therapy. In one of the two remaining cases there was a significant decrease in hCt serum level only after neck dissection, and in the last case further dissemination was observed. Conclusions: In three patients we observed partial response (ie regression), and in the remaining two no response (ie continuation of disease progression).

medullary thyroid cancer, MIBG therapy

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