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131 I‐ MIBG therapy for malignant paraganglioma and phaeochromocytoma: systematic review and meta‐analysis
Author(s) -
Hulsteijn L. T.,
Niemeijer N. D.,
Dekkers O. M.,
Corssmit E. P. M.
Publication year - 2014
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12341
Subject(s) - paraganglioma , medicine , meta analysis , radionuclide therapy , confidence interval , logistic regression , pooled analysis , oncology , urology , pathology
Summary Background 131 I‐ MIBG therapy can be used for palliative treatment of malignant paraganglioma and phaeochromocytoma. The main objective of this study was to perform a systematic review and meta‐analysis assessing the effect of 131 I‐ MIBG therapy on tumour volume in patients with malignant paraganglioma/phaeochromocytoma. Methods A literature search was performed in December 2012 to identify potentially relevant studies. Main outcomes were the pooled proportions of complete response, partial response and stable disease after radionuclide therapy. A meta‐analysis was performed with an exact likelihood approach using a logistic regression with a random effect at the study level. Pooled proportions with 95% confidence intervals ( CI ) were reported. Results Seventeen studies concerning a total of 243 patients with malignant paraganglioma/phaeochromocytoma were treated with 131 I‐ MIBG therapy. The mean follow‐up ranged from 24 to 62 months. A meta‐analysis of the effect of 131 I‐ MIBG therapy on tumour volume showed pooled proportions of complete response, partial response and stable disease of, respectively, 0·03 (95% CI : 0·06–0·15), 0·27 (95% CI : 0·19–0·37) and 0·52 (95% CI : 0·41–0·62) and for hormonal response 0·11 (95% CI : 0·05–0·22), 0·40 (95% CI : 0·28–0·53) and 0·21 (95% CI : 0·10–0·40), respectively. Separate analyses resulted in better results in hormonal response for patients with paraganglioma than for patients with phaeochromocytoma. Conclusions Data on the effects of 131 I‐ MIBG therapy on malignant paraganglioma/phaeochromocytoma suggest that stable disease concerning tumour volume and a partial hormonal response can be achieved in over 50% and 40% of patients, respectively, treated with 131 I‐ MIBG therapy. It cannot be ruled out that stable disease reflects not only the effect of MIBG therapy, but also (partly) the natural course of the disease.