Objective: This study describes the initial experience in the use of low-dose I-131 MIBG in patients with metastatic/ refractory Neuroblastoma given at 18.5 Mbq/ Kg (0.5 mCi/Kg )to (1) achieve disease palliation (i.e., pain / symptom control) and improvement in the quality of life, through subjective response from patient/ carers and (2) allow day-admission to minimize hospital stay providing more quality time between the patients and carers.

Methods: Patients with refractory and metastatic Neuroblastoma whose primary treatment goal at that particular stage is pain palliation were given low-dose I-131 MIBG at a dose of 18.5 Mbq/ Kg ( 0.5 mCi/ Kg)l. Assessment of subjective pain relief following I-131 MIBG was done through interviews from hospital visits of the patient and home visits by the team.

Results: Four patients underwent Low-Dose I-131 MIBG Therapy for pain palliation between May 2007- March 2008. Median age was 5.75 years old and median total dose given was 539 Mbq/ patient (14.5 mCi/ patient). All patients at a certain time had relief from disease pain allowing them to communicate with family and participate in physical activities not priviledged before. Observations gathered from carers/ parents revealed that the overall quality-of-life improved after the I-131 MIBG therapy with concurrent pain medication protocol.

Conclusion: This initial / pilot study described achievement of disease palliation (i.e., pain and symptom control) and improvement in the quality of life of Stage IV Neuroblastoma patients and allows day-admissions providing more quality time between the patient and the family and reduces patient anxiety.