Scintigraphic response by123I-metaiodobenzylguanidine scan correlates with event-free survival in high-risk neuroblastoma

Howard M. Katzenstein, Susan L. Cohn, Richard M. Shore, Dianna M E Bardo, Paul Haut, Marie Olszewski, Jennifer Schmoldt, Dachao Liu, Alfred W. Rademaker, Morris Kletzel

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Abstract

Purpose: To investigate whether response to induction therapy, evaluated by metaiodobenzylguanadine (MIBG) and bone scintigraphy, correlates with event-free survival (EFS) in children with high-risk neuroblastoma (NB). Patients and Methods: Twenty-nine high-risk NB patients were treated prospectively with an intensive induction regimen and consolidated with three cycles of high-dose therapy with peripheral blood stem-cell rescue. The scintigraphic response was evaluated by MIBG and bone scans using a semi-quantitative scoring system. The prognostic significance of the imaging scores at diagnosis and following induction therapy was evaluated. Results: A trend associating worse 4-year EFS rates for patients with versus without osteomedullary uptake on MIBG scintigraphs at diagnosis was seen (35% ± 11% v 80% ± 18%, respectively; P = .13). Similarly, patients with positive bone scans at diagnosis had worse EFS than those with negative scans, although the difference did not receive statistical significance (34% ± 10% v 83% ± 15%, respectively; P = .06). However, significantly worse EFS was observed in patients with a postinduction MIBG score of ≥ 3 compared to those with scores of less than 3 (0% v 58% ± 11%; P = .002). There was no correlation between bone scan scores and outcome following induction therapy. Conclusion: MIBG scores ≥ 3 following induction therapy identifies a subset of NB patients who are likely to relapse following three cycles of high-dose therapy with peripheral blood stem-cell rescue, local radiotherapy, and 13-cis-retinoic acid. Alternative therapeutic strategies should be considered for patients with a poor response to induction therapy.

Original languageEnglish
Pages (from-to)3909-3915
Number of pages7
JournalJournal of Clinical Oncology
Volume22
Issue number19
DOIs
StatePublished - 2004

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Neuroblastoma
Disease-Free Survival
Bone and Bones
Therapeutics
Isotretinoin
Radionuclide Imaging
Radiotherapy
Survival Rate
Recurrence

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Scintigraphic response by123I-metaiodobenzylguanidine scan correlates with event-free survival in high-risk neuroblastoma. / Katzenstein, Howard M.; Cohn, Susan L.; Shore, Richard M.; Bardo, Dianna M E; Haut, Paul; Olszewski, Marie; Schmoldt, Jennifer; Liu, Dachao; Rademaker, Alfred W.; Kletzel, Morris.

In: Journal of Clinical Oncology, Vol. 22, No. 19, 2004, p. 3909-3915.

Research output: Contribution to journalArticle

Katzenstein, HM, Cohn, SL, Shore, RM, Bardo, DME, Haut, P, Olszewski, M, Schmoldt, J, Liu, D, Rademaker, AW & Kletzel, M 2004, 'Scintigraphic response by123I-metaiodobenzylguanidine scan correlates with event-free survival in high-risk neuroblastoma', Journal of Clinical Oncology, vol. 22, no. 19, pp. 3909-3915. https://doi.org/10.1200/JCO.2004.07.144
Katzenstein, Howard M. ; Cohn, Susan L. ; Shore, Richard M. ; Bardo, Dianna M E ; Haut, Paul ; Olszewski, Marie ; Schmoldt, Jennifer ; Liu, Dachao ; Rademaker, Alfred W. ; Kletzel, Morris. / Scintigraphic response by123I-metaiodobenzylguanidine scan correlates with event-free survival in high-risk neuroblastoma. In: Journal of Clinical Oncology. 2004 ; Vol. 22, No. 19. pp. 3909-3915.
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abstract = "Purpose: To investigate whether response to induction therapy, evaluated by metaiodobenzylguanadine (MIBG) and bone scintigraphy, correlates with event-free survival (EFS) in children with high-risk neuroblastoma (NB). Patients and Methods: Twenty-nine high-risk NB patients were treated prospectively with an intensive induction regimen and consolidated with three cycles of high-dose therapy with peripheral blood stem-cell rescue. The scintigraphic response was evaluated by MIBG and bone scans using a semi-quantitative scoring system. The prognostic significance of the imaging scores at diagnosis and following induction therapy was evaluated. Results: A trend associating worse 4-year EFS rates for patients with versus without osteomedullary uptake on MIBG scintigraphs at diagnosis was seen (35{\%} ± 11{\%} v 80{\%} ± 18{\%}, respectively; P = .13). Similarly, patients with positive bone scans at diagnosis had worse EFS than those with negative scans, although the difference did not receive statistical significance (34{\%} ± 10{\%} v 83{\%} ± 15{\%}, respectively; P = .06). However, significantly worse EFS was observed in patients with a postinduction MIBG score of ≥ 3 compared to those with scores of less than 3 (0{\%} v 58{\%} ± 11{\%}; P = .002). There was no correlation between bone scan scores and outcome following induction therapy. Conclusion: MIBG scores ≥ 3 following induction therapy identifies a subset of NB patients who are likely to relapse following three cycles of high-dose therapy with peripheral blood stem-cell rescue, local radiotherapy, and 13-cis-retinoic acid. Alternative therapeutic strategies should be considered for patients with a poor response to induction therapy.",
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T1 - Scintigraphic response by123I-metaiodobenzylguanidine scan correlates with event-free survival in high-risk neuroblastoma

AU - Katzenstein, Howard M.

AU - Cohn, Susan L.

AU - Shore, Richard M.

AU - Bardo, Dianna M E

AU - Haut, Paul

AU - Olszewski, Marie

AU - Schmoldt, Jennifer

AU - Liu, Dachao

AU - Rademaker, Alfred W.

AU - Kletzel, Morris

PY - 2004

Y1 - 2004

N2 - Purpose: To investigate whether response to induction therapy, evaluated by metaiodobenzylguanadine (MIBG) and bone scintigraphy, correlates with event-free survival (EFS) in children with high-risk neuroblastoma (NB). Patients and Methods: Twenty-nine high-risk NB patients were treated prospectively with an intensive induction regimen and consolidated with three cycles of high-dose therapy with peripheral blood stem-cell rescue. The scintigraphic response was evaluated by MIBG and bone scans using a semi-quantitative scoring system. The prognostic significance of the imaging scores at diagnosis and following induction therapy was evaluated. Results: A trend associating worse 4-year EFS rates for patients with versus without osteomedullary uptake on MIBG scintigraphs at diagnosis was seen (35% ± 11% v 80% ± 18%, respectively; P = .13). Similarly, patients with positive bone scans at diagnosis had worse EFS than those with negative scans, although the difference did not receive statistical significance (34% ± 10% v 83% ± 15%, respectively; P = .06). However, significantly worse EFS was observed in patients with a postinduction MIBG score of ≥ 3 compared to those with scores of less than 3 (0% v 58% ± 11%; P = .002). There was no correlation between bone scan scores and outcome following induction therapy. Conclusion: MIBG scores ≥ 3 following induction therapy identifies a subset of NB patients who are likely to relapse following three cycles of high-dose therapy with peripheral blood stem-cell rescue, local radiotherapy, and 13-cis-retinoic acid. Alternative therapeutic strategies should be considered for patients with a poor response to induction therapy.

AB - Purpose: To investigate whether response to induction therapy, evaluated by metaiodobenzylguanadine (MIBG) and bone scintigraphy, correlates with event-free survival (EFS) in children with high-risk neuroblastoma (NB). Patients and Methods: Twenty-nine high-risk NB patients were treated prospectively with an intensive induction regimen and consolidated with three cycles of high-dose therapy with peripheral blood stem-cell rescue. The scintigraphic response was evaluated by MIBG and bone scans using a semi-quantitative scoring system. The prognostic significance of the imaging scores at diagnosis and following induction therapy was evaluated. Results: A trend associating worse 4-year EFS rates for patients with versus without osteomedullary uptake on MIBG scintigraphs at diagnosis was seen (35% ± 11% v 80% ± 18%, respectively; P = .13). Similarly, patients with positive bone scans at diagnosis had worse EFS than those with negative scans, although the difference did not receive statistical significance (34% ± 10% v 83% ± 15%, respectively; P = .06). However, significantly worse EFS was observed in patients with a postinduction MIBG score of ≥ 3 compared to those with scores of less than 3 (0% v 58% ± 11%; P = .002). There was no correlation between bone scan scores and outcome following induction therapy. Conclusion: MIBG scores ≥ 3 following induction therapy identifies a subset of NB patients who are likely to relapse following three cycles of high-dose therapy with peripheral blood stem-cell rescue, local radiotherapy, and 13-cis-retinoic acid. Alternative therapeutic strategies should be considered for patients with a poor response to induction therapy.

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