{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:29:28Z","timestamp":1791156568432,"version":"4.1.0"},"reference-count":19,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"25","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2009,9,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To evaluate the safety and efficacy of high-dose [<jats:sup>131<\/jats:sup>I]metaiodobenzylguanidine ([<jats:sup>131<\/jats:sup>I]MIBG) in the treatment of malignant pheochromocytoma (PHEO) and paraganglioma (PGL). <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Fifty patients with metastatic PHEO or PGL, age 10 to 64 years, were treated with [<jats:sup>131<\/jats:sup>I]MIBG doses ranging from 492 to 1,160 mCi (median, 12 mCi\/kg). Cumulative [<jats:sup>131<\/jats:sup>I]MIBG administered ranged from 492 to 3,191 mCi. Autologous hematopoietic stem cells were collected and cryopreserved before treatment with [<jats:sup>131<\/jats:sup>I]MIBG greater than 12 mCi\/kg or with a total dose greater than 500 mCi. Sixty-nine [<jats:sup>131<\/jats:sup>I]MIBG infusions were given, which included infusions to 35 patients treated once and infusions to 15 patients who received two or three treatments. Response was evaluated by [<jats:sup>123<\/jats:sup>I]MIBG scans, computed tomography\/magnetic resonance imaging, urinary catecholamines\/metanephrines, and chromogranin A. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> The overall complete response (CR) plus partial response (PR) rate in 49 evaluable patients was 22%. Additionally, 35% of patients achieved a CR or PR in at least one measure of response without progressive disease, and 8% of patients maintained stable disease for greater than 12 months. Thirty-five percent of patients experienced progressive disease within 1 year after therapy. The estimated 5-year overall survival rate was 64%. Toxicities included grades 3 to 4 neutropenia (87%) and thrombocytopenia (83%). Grades 3 to 4 nonhematologic toxicity included acute respiratory distress syndrome (n = 2), bronchiolitis obliterans organizing pneumonia (n = 2), pulmonary embolism (n = 1), fever with neutropenia (n = 7), acute hypertension (n = 10), infection (n = 2), myelodysplastic syndrome (n = 2), and hypogonadism (n = 4). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Although serious toxicity may occur, the survival and response rates achieved with high-dose [<jats:sup>131<\/jats:sup>I]MIBG suggest its utility in the management of selected patients with metastatic PHEO and PGL. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2008.21.3496","type":"journal-article","created":{"date-parts":[[2009,7,28]],"date-time":"2009-07-28T01:47:06Z","timestamp":1248745626000},"page":"4162-4168","source":"Crossref","is-referenced-by-count":229,"title":["Phase II Study of High-Dose [<sup>131<\/sup>I]Metaiodobenzylguanidine Therapy for Patients With Metastatic Pheochromocytoma and Paraganglioma"],"prefix":"10.1200","volume":"27","author":[{"given":"Sara","family":"Gonias","sequence":"first","affiliation":[{"name":"From the Departments of Pediatrics, Nuclear Medicine, Medicine, and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Goldsby","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics, Nuclear Medicine, Medicine, and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine K.","family":"Matthay","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics, Nuclear Medicine, Medicine, and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Hawkins","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics, Nuclear Medicine, Medicine, and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Price","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics, Nuclear Medicine, Medicine, and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Huberty","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics, Nuclear Medicine, Medicine, and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, 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