Objective
Neuroblastoma is a common extracranial solid tumor of childhood. Recently, multiple treatments have been practiced including Iodine-131-metaiodobenzylguanidine radiation (131I-MIBG) therapy. However, the efficacy varies greatly. The aim of this meta-analysis is to evaluate the efficacy of 131I-MIBG for relapsed or refractory neuroblastoma and to provide evidence and hints for clinical decision-making.
Methods
Medline, EMBASE database and the Cochrane Library were searched for relevant studies. Eligible studies were clinical trials of refractory assigned to 131I-MIBG with data on efficacy including tumor response. The overall efficacy was calculated using a random-effects model considering of the heterogeneity.
Results
A total of 26 clinical trials including 883 patients were analyzed. The overall rates of objective response SD, PD and MR was 39% (95% CI: 32%-47%), 31% (95% CI: 24%, 37%), 22% (95% CI: 15%, 30%) and 15% (95% CI: 3%, 31%), respectively. Overall objective response rates of 131I-MIBG in combination with chemotherapy was 28%(95% CI: 14%, 44%). Median event-free survival (EFS) ranged from 10 to 16 months in the studies included.
Conclusion
131I-MIBG treatment is effective on clinical outcomes in relapsed or refractory neuroblastoma, more randomized-controlled clinical trials investigating the efficacy of 131I-MIBG in combination with chemotherapy should be conducted.