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@ARTICLE{Maric:241154,
      author       = {I. Maric$^*$ and M. Weber$^*$ and A. Prochnow and J.
                      Schmitz$^*$ and N. Unger$^*$ and B. M. Schaarschmidt$^*$ and
                      T. D. Poeppel and C. Rischpler$^*$ and A. Bockisch$^*$ and
                      K. Herrmann$^*$ and W. Jentzen$^*$ and W. P. Fendler$^*$},
      title        = {{E}fficacy and safety of 124{I}-m{IBG} dosimetry-guided
                      high activity 131{I}-m{IBG} therapy of advanced
                      pheochromocytoma or neuroblastoma.},
      journal      = {Journal of nuclear medicine},
      volume       = {64},
      number       = {6},
      issn         = {0097-9058},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {DKFZ-2023-00262},
      pages        = {885-891},
      year         = {2023},
      note         = {2023 Jun;64(6):885-891},
      abstract     = {Introduction: We aim to evaluate the efficacy and safety of
                      124I-mIBG dosimetry guided high-activity 131I-mIBG therapy
                      of advanced pheochromocytoma or neuroblastoma. Methods:
                      Fourteen patients with advanced pheochromocytoma or
                      neuroblastoma, age 9 to 69 years, underwent 124I-mIBG PET
                      scans and whole-body retention measurements to assess the
                      whole-body dose as a surrogate of bone marrow toxicity and
                      tumor (absorbed) dose per unit of administered activity.
                      Dosimetry results together with individual patient
                      characteristics were combined to guide a single therapeutic
                      activity to achieve a high tumor dose without exceeding
                      toxicity threshold. Toxicity was assessed for hematologic,
                      hepatic as well as renal function. Response was evaluated by
                      RECIST, SIOPEN-like score, change in PET uptake and
                      quantitative PET parameters (SUVmax, SUVpeak, MTV, TLG) as
                      well as visual decrease in number and/or in visual intensity
                      of lesions on baseline to follow-up 124I-mIBG-PET/CT.
                      Results: The mean therapeutic activity was 14 GBq. Eleven of
                      14 patients $(79\%)$ received each more than 10 GBq. One
                      male patient was treated with a single activity of 50 GBq.
                      Three patients were treated with lower activities between
                      3.5 and 7.0 GBq. Median overall survival was 85 months
                      $(95\%$ CI), median progression-free survival was 25 months
                      $(95\%$ CI). Four $(29\%)$ and 5 $(36\%)$ patients
                      demonstrated response (CR or PR) by RECIST and functional
                      imaging, respectively. One patient exceeded whole-body dose
                      of 2 Gy and demonstrated grade 3 hematologic toxicity, which
                      resolved spontaneously within 12 months after the therapy
                      without the need for further treatment. Three patients
                      $(21\%)$ demonstrated transient grade 1 renal toxicity.
                      Conclusion: 124I-mIBG dosimetry-guided high-activity
                      131I-mIBG therapy in patients with advanced pheochromocytoma
                      or neuroblastoma resulted in durable responses with a low
                      rate of manageable adverse events. Efficacy of
                      124I-mIBG-guided activity escalation should further be
                      assessed in a prospective setting.},
      keywords     = {Oncology: Endocrine (Other) / Oncology: General (Other) /
                      Radiation Therapy Planning (Other) / Radionuclide Therapy
                      (Other) / dosimetry (Other) / mIBG (Other) / theranostics
                      (Other) / therapy (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36732054},
      doi          = {10.2967/jnumed.122.264775},
      url          = {https://inrepo02.dkfz.de/record/241154},
}