Comparison of (1)(2)(3)I-metaiodobenzylguanidine (MIBG) and (1)(3)(1)I-MIBG semi-quantitative scores in predicting survival in patients with stage 4 neuroblastoma: a report from the Children's Oncology Group.
Author(s): Naranjo A, Parisi MT, Shulkin BL, London WB, Matthay KK, Kreissman SG, Yanik GA
Affiliation(s): Children's Oncology Group, University of Florida, Gainesville, Florida, USA. email@example.com
Publication date & source: 2011-07-01, Pediatr Blood Cancer., 56(7):1041-5. Epub 2011 Feb 15.
Publication type: Comparative Study; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural
BACKGROUND: (1)(2)(3)I-metaiodobenzylguanidine (MIBG) scans are preferable to (1)(3)(1)I-MIBG for neuroblastoma imaging as they deliver less patient radiation yet have greater sensitivity in disease detection. Both (1)(2)(3)I-MIBG and (1)(3)(1)I-MIBG scans were used for disease assessments of neuroblastoma patients enrolled on Children's Oncology Group (COG) high-risk study A3973. The hypothesis was that (1)(2)(3)I-MIBG and (1)(3)(1)I-MIBG scans were sufficiently similar for clinical purposes in terms of ability to predict survival. PROCEDURE: Patients enrolled on COG A3973 with stage 4 disease who completed (1)(2)(3)I-MIBG or (1)(3)(1)I-MIBG scans at diagnosis, post-induction, post-transplant, or post-biotherapy were analyzed. The performance of the Curie score for each MIBG scan type in predicting survival was evaluated. At each time point, survival curves for (1)(2)(3)I-MIBG versus (1)(3)(1)I-MIBG were compared using the log-rank test. RESULTS: Of the 413 patients on A3973 with at least one MIBG scan, 350 were stage 4. The 5-year event-free survival (EFS) and overall survival (OS) rates were 33.4 +/- 3.6% and 45.6 +/- 4.0% (N = 350). At post-induction, EFS (P = 0.3501) and OS (P = 0.5337) for (1)(2)(3)I-MIBG versus (1)(3)(1)I-MIBG were not significantly different. Similarly, comparisons at the three other time points were non-significant. CONCLUSIONS: We found no evidence of a statistically significant difference in outcome by type of scan. For future survival analyses of MIBG Curie scores, (1)(2)(3)I-MIBG and (1)(3)(1)I-MIBG results may be combined and analyzed overall, without adjustment for scan type. Copyright (c) 2011 Wiley-Liss, Inc.