What is I-131-MIBG therapy?
I-131-MIBG therapy is a type of radiation therapy used to kill cancer cells in children with certain kinds of cancer. It’s a way to get radiation inside your child’s body to target cancer cells wherever they are.
The medicine is a clear fluid that looks like water. This treatment is given by infusion through an intravenous (IV) line or central line. The fluid is slowly pumped through the line into your child’s bloodstream so it can travel throughout their body.
The fluid contains I-131 and MIBG. I-131 is a kind of radioactive iodine. This is what gives off radiation to destroy the cancer. When it is attached to MIBG (another chemical), it brings the radiation into the tumor.
Once inside the cancer cells, the iodine gives off particles of radiation (beta radiation) that travel outward about half an inch in all directions. This kills the cancer cells and the cells around them.
The infusion is done in the hospital. It takes about two hours. After the infusion, you and your child stay in the hospital for about a week. For five to seven days, your child’s body fluids (like urine, sweat and saliva) will give off radiation that could harm others. Special plans are followed to make sure your child gets the care they need but to contain the radiation at the same time.
What conditions does it treat?
I-131-MIBG therapy is used only for tumors that take up MIBG, such as neuroblastoma and some tumors of the adrenal glands (pheochromacytoma).
Radiation works well against neuroblastoma. But neuroblastoma may spread to many places in a child’s body. So the most common way of giving radiation – sending a beam of radiation toward one spot – is not always useful. I-131-MIBG therapy works because it’s a way to get radiation to neuroblastoma cells all around your child’s body from the inside via the bloodstream.
What’s special about I-131-MIBG therapy at Seattle Children’s?
Seattle Children’s is the only hospital in the Pacific Northwest and one of only about 12 centers in the country that offer I-131-MIBG therapy for children. It’s part of our commitment to bring the best and newest treatments to all children with cancer. I-131-MIBG works because the beta radiation from the iodine damages cells. To treat your child safely and to keep your family, other patients and the hospital staff safe, I-131-MIBG must be given with great care. Hospitals need special rooms and equipment, as well as a full team of healthcare providers with special training, to offer this treatment.
Your child's I-131-MIBG team
At Seattle Children’s, we have a team of nuclear medicine doctors, nuclear medicine technicians, oncologists and oncology nurses trained in how to give I-131-MIBG therapy safely.
During the week after the infusion, you will need to provide some of your child’s care. The team gives you detailed training before treatment starts about what you will need to do, and we work closely with you during your child’s hospital stay. Our social workers and child life specialists also help support you and your family.
Our special I-131-MIBG facilities
We have a hospital room just for children getting I-131-MIBG therapy.
- The door and walls of the room are lined with lead, which stops radiation.
- The room is set up so you can be near your child without being exposed to too much radiation yourself. A movable lead shield is next to your child’s bed. When you’re in the room, you stand behind this shield to limit your exposure.
- A radiation meter in the room tells your child’s care team how much radiation your child is giving off.
- All surfaces and any objects your child might touch are wrapped in plastic to prevent direct contact with your child’s bodily fluids.
- A special TV system in the room lets you see and hear your child from outside the room. Your child can see and hear you too.
To be near your child, you will stay in a family room that has a sleep chair or bed. It will be across the hall from your child’s room.
To limit the risk of picking up radiation or tracking it out of your child’s room, there are strict safety rules. For example, you must wear a paper gown, gloves and booties over your shoes in your child’s room and take them off at the door. You will wear a small device (dosimeter) to check how much radiation you’ve been exposed to. You will also use a radiation meter that’s right outside your child’s door. Your child’s team will explain all the safety rules.
Who needs I-131-MIBG therapy?
Children with neuroblastoma that has come back may be able to have I-131-MIBG therapy. This is a newer treatment, so it’s offered only through research studies (clinical trials).
Some children may be able to get I-131-MIBG therapy through an option called compassionate use. This means the U.S. Food and Drug Administration lets a company give a drug to a patient before the drug is approved and without the patient taking part in a study.
In the future, I-131-MIBG therapy may be used as part of the treatment for all children with high-risk neuroblastoma. Before this can happen, researchers need more study results to tell whether standard treatment plus I-131-MIBG therapy may work at least as well as standard treatment alone.
For more information, please call 206-987-2106 or send us an email.
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