Division of Endocrinology at The Children's Hospital of Philadelphia, Philadelphia, PA, USA. lessigm@email.chop.edu
Despite aggressive research and treatment, high-risk neuroblastoma continues to have a devastating mortality rate of more than 40%. Research conducted over the past 2 decades has shown that the radioisotope (131)I-MIBG (metaiodobenzylguanidine) is effective in the treatment of this difficult patient population. The purpose of this article is to review the diagnosis, staging, and conventional treatment of neuroblastoma and to understand the mechanism of action of MIBG and ( 131)I-MIBG. This article also reviews treatments for high-risk neuroblastoma patients and analyzes recent research studies that used (131)I-MIBG to better define the role of this treatment in high-risk neuroblastoma patients. In addition, this article explores the role of the advanced practice nurse to serve at the forefront in the implementation of a multidisciplinary ( 131)I-MIBG treatment program.