methimazole and Neuroblastoma

Topics: Adolescent; Antithyroid Agents; Blepharoptosis; Child, Preschool; Diagnosis, Differential; DNA, Mitochondrial; Female; Graves Disease; Humans; Immunoglobulins, Intravenous; Infant; Male; Methimazole; Mutation; Neuroblastoma; Paraneoplastic Syndromes, Nervous System

During radiolabeled metaiodobenzylguanidine (MIBG) administration in children with neuroblastoma, the thyroid is protected from (123/131)I uptake by potassium iodide. Despite this protection, up to 64% of patients develop thyroid dysfunction. The authors introduce a new method of radiation protection for the thyroid gland.. In a prospective cohort study, 34 children with neuroblastoma who received MIBG were given thyroxine, methimazole, and potassium iodide for protection of the thyroid gland. Protection started 1 day before the start of diagnostic 123I-MIBG and was continued until 4 weeks after the last therapeutic 131I-MIBG dose. Follow-up measurements were performed every 3 months after the protection was stopped. Visualization of the thyroid on MIBG images was reviewed by three nuclear medicine physicians. Results were compared with a historic control group of children who had received potassium iodide for thyroid protection during MIBG administration.. After a mean follow-up of 19 months, there were 23 evaluable patients. Thyroid function was normal in 86% of survivors compared with 44% of children in the historic control group (P=0.011; Pearson chi-square test). Scintigraphic visualization of the thyroid diminished substantially after the new protection (21.5% vs. 5.3%, respectively; P=0.000).. The results of the current study indicate that compared with potassium iodide alone, combined thyroxine, methimazole, and potassium iodide protect the thyroid more effectively against radiation damage from (123/131)I during diagnostic and therapeutic MIBG administration in children with neuroblastoma.

Topics: 3-Iodobenzylguanidine; Antineoplastic Agents; Child; Child, Preschool; Female; Humans; Infant; Male; Methimazole; Neuroblastoma; Potassium Iodide; Radiation-Protective Agents; Thyroid Diseases; Thyroid Function Tests; Thyroxine; Treatment Outcome