(131)I-MIBG radionuclide therapy is safe and cost-effective in the control of symptoms of the carcinoid syndrome

Eur J Surg Oncol. 2001 Jun;27(4):404-8. doi: 10.1053/ejso.2001.1132.


Background: The standard treatment used to control the symptoms of carcinoid syndrome (CS) involves subcutaneous injections of the somatostatin analogue octreotide. This is expensive (US $8000--16,000 per year), and treatment may be for many years. The aim of this study was to evaluate the efficacy and cost-effectiveness of our experience over the last 5 years with 1-131-labelled metaiodobenzylguanidine (MIBG) radionuclide therapy in the palliation of patients with CS.

Methods: A consecutive series of 20 symptomatic patients (referred between 1994 and 1999) with CS were evaluated. Fifteen of them underwent(123)I-MIBG scanning. Of the 13 patients with significant tracer uptake in metastatic deposits compared to background, 12 underwent a course of therapeutic(131)I-MIBG (one patient refused). Symptoms, biochemical markers, CT scans, follow-up(123)I-MIBG scans, and the requirement for octreotide were used to assess outcome of treatment. Costs of(131)I-MIBG and octreotide treatments were compared.

Results: MIBG treatment was well tolerated in all with only transient side-effects. Ten patients showed a measurable clinical improvement. Seven had a complete clinical response. The mean duration of response was 15.4 months. Octreotide was not required or was reduced in eight patients. Treatment with(131)I-MIBG resulted in a saving of US $1000 per patient, with effective symptom control, when compared to octreotide.

Conclusion: 1-131 MIBG therapy is a safe and cost-effective therapeutic option to successfully control symptoms in patients with carcinoid syndrome.

MeSH terms

  • 3-Iodobenzylguanidine / economics*
  • 3-Iodobenzylguanidine / therapeutic use*
  • Aged
  • Antineoplastic Agents / economics*
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Carcinoid Tumor / diagnostic imaging
  • Carcinoid Tumor / economics*
  • Carcinoid Tumor / therapy*
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Male
  • Middle Aged
  • Octreotide / therapeutic use
  • Radionuclide Imaging
  • Radiopharmaceuticals / therapeutic use
  • Syndrome
  • Treatment Outcome
  • United Kingdom


  • Antineoplastic Agents
  • Antineoplastic Agents, Hormonal
  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine
  • Octreotide