In a medical first for India, doctors at Tata Memorial Centre’s Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Kharghar, administered a record-breaking radiation dose to a 17-year-old patient with stage 4 neuroblastoma. The complex procedure required lead-shielded treatment chambers, evacuation of nearby rooms, and multiple safety drills before two high-dose radioactive injections were administered just 15 seconds apart.
Months of Planning and International Collaboration
As reported by TOI, the team spent over three months meticulously planning the high-risk procedure. They coordinated closely with experts at Sloan Kettering Cancer Center in New York, who had previously performed over 100 such therapies. “Our confidence grew after learning that ACTREC already had much of the necessary infrastructure,” said Dr. Archi Agrawal, Head of Nuclear Medicine, who led the procedure.
A Safer, Cheaper Alternative for High-Risk Neuroblastoma
This cutting-edge treatment—administered for the first time in India—could significantly alter how high-risk neuroblastoma is managed. Currently, treating such patients involves multiple therapies, including anti-GD2 immunotherapy, pushing costs up to ₹75 lakh. In contrast, this targeted radiotherapy could be provided for ₹4–5 lakh.
Successful Procedure and Recovery
Doctors administered the 131I-mIBG therapy on May 5. They kept the patient under strict isolation, discharged him after five days, and declared him out of immediate danger this week. However, they cautioned that only a two-year relapse-free period will confirm the treatment outcome.
Understanding the Therapy: Precision with Protection
The treatment involves attaching a radioactive iodine isotope (I-131) to the MIBG molecule, which selectively targets neuroblastoma cells. This approach delivers radiation directly to the tumor while sparing healthy tissues. “Until now, only 200–300 millicurie doses were used. We aimed for 800 millicuries—four times higher than the standard and the highest ever given in India,” said Dr. Venkatesh Rangarajan from the Nuclear Medicine Department.
Extreme Safety Protocols and Radiation Management
Post-therapy, the patient remained highly radioactive, with even bodily fluids posing exposure risks. Doctors collected urine and stool in specialized ‘delay-decay’ tanks, which hold radioactive waste until its radiation levels drop to safe limits. To ensure complete safety, the Atomic Energy Regulatory Board (AERB) sent two officials to monitor the process. Dr. Agrawal noted, “We left nothing to chance. The safety of the patient and staff was non-negotiable.”
Teamwork Across Departments and High-Risk Preparedness
Departments across the hospital—including paediatric oncology, bone marrow transplant, haematology, and transfusion medicine—collaborated on the procedure. The treatment team had to manage everything, from food to clinical assessments, through the door of the isolation chamber. “Had the patient experienced a hypertensive crisis, I was prepared to enter despite the risk of radiation exposure,” said Dr. Agrawal. “Thankfully, that wasn’t necessary.”
Hope with Caution: Next Steps and Clinical Trials
Dr. Navin Khatry from the Haematology Department explained that this therapy is currently reserved for relapsed patients, given its experimental nature. “The cure rate with this therapy is about 30%, with relapse occurring in two to three years. We will proceed with clinical trials before offering this to a broader group of patients,” he said.
This landmark procedure marks a major stride in paediatric oncology, bringing hope for more affordable and targeted cancer care in India—backed by rigorous science and uncompromising safety.