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131I MIBG therapy

Children with high-risk refractory or recurrent neuroblastoma are eligible for 131I MIBG treatment. In this treatment, radioactive iodine is linked to the protein MIBG. This protein ensures that the radioactive iodine reaches the tumor and metastases through the bloodstream and irradiates them in situ.

Because children still emit some radiation to their surroundings (people and material) after this treatment, they are nursed in isolation and measures are taken to limit the radiation to their surroundings.  

131I MIBG therapy in children is only performed in a select number of locations worldwide; the Princess Máxima Center is one of the centers with expertise, experience and facilities. We are opening up MIBG therapy internationally, both as part of a study (VERITAS study) and as a separate treatment. We have two available MIBG treatment rooms and across the hallway two parents/ guardians rooms.

Treatment program

The 131I MIBG treatment consists of two inpatient stays and three outpatient appointments. The average total length of stay in the Netherlands is about four to six weeks. After the last appointment in the Máxima Center, a child returns home as soon as possible. This enables the stem cell reinfusion (rescue of cell line recovery; especially thrombocytopenia (low platelets) after treatment) and further treatment or follow-up can take place at home.

The 131I MIBG treatment program:

  • Day -4: arrival at the Máxima Center in the week before the start of MIBG therapy, on Thursday at the latest. First outpatient appointment with doctor/nurse practitioner and radiation oncologist.
  • Day 1-7: first therapy (admission on Monday and administration on Tuesday)
  • Day 8-14: external stay
  • Day 17: outpatient appointment
  • Day 15-21: second therapy: admission and administration
  • Day 22-25: external stay
  • Day 24: outpatient appointment
  • Day 25: Going home

The MIBG Treatment Team