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Tata Memorial Centre to provide affordable high-dose MIBG therapy for neuroblastoma

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Mumbai: A high-dose MIBG (metaiodobenzylguanidine) therapy for treating neuroblastoma, a type of cancer mostly found in children, will be provided at an affordable cost of Rs 7-8 lakh at a research body associated with the Tata Memorial Centre ( TMC).

The Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), a unit of TMC at Kharghar in Navi Mumbai, treated a 17-year-old with a supra-high dose of 131I-mIBG on May 5.

Talking to reporters on Friday, TMC director Dr Sudeep Gupta said the treatment of children with high-risk neuroblastoma, which requires a multi-modality approach including anti-GD2 immunotherapy, costs around Rs 75 lakh and has a long-term cure outcome of 50 per cent.

"The anti-GD2 immunotherapy is exceptionally expensive and is not accessible to many patients in India. However, the high-dose 131I-mIBG therapy costing Rs 7-8 lakh is affordable. With 41 'hot beds' medical isolation ward, the largest in the world, the TMC plans to routinely provide this treatment to eligible patients with high-risk neuroblastoma," he said.

Even the toilet and wash water from the room are piped to a sealed "delay-decay" tank so the radioactivity can fade before the wastewater is released into the regular sewer system.

This is the first high-dose 131I-mIBG therapy administered in India with a 25-35 per cent long-term cure outcome, where the patient was administered 800 mCI of 131I-mIBG.

In India, the standard dose of 131I-mIBG is 5 millicuries per kilogram (maximum 300 mCI).

"The previous highest total dose of 131I-mIBG in a single setting in India has been 300 mCI. Specialists from the departments of nuclear medicine, paediatric oncology, haematological oncology (bone marrow transplant) and transfusion medicine were involved in the planning and execution of this complex treatment," Dr Gupta said.

For the higher dose, the Atomic Energy Regulatory Board (AERB) gave its approval after the TMC submitted a report from a simulation experiment at the premises, addressing issues such as isolation protocols, radiation safety concerns, dosimetry calculations, patient monitoring and management of emergency crises.

He said this treatment requires coordination of doctors, physicists, technical staff, nurses and auxiliary staff from the departments of nuclear medicine, paediatric and haematological oncology (bone marrow transplant unit) and transfusion medicine, and the Board of Radiation and Isotope Technology (BRIT).

In India, 1,500 children are detected with neuroblastoma annually, Dr Gupta added. PTI
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