A Study on Ways to Optimize the Period of Hospitalization During High-Dose $^{131}I$ Treatment of the Thyroid Cancer

갑상선암의 고용량 $^{131}I$ 치료 시 입원기간의 최적화방안 연구

  • Baek, Seong-Min (Dept. of Nuclear Medicine Kosin University Gospel hospital) ;
  • Ko, Seong-Jin (Dept. of Radiological Science, College of Health Science, Catholic University of Pusan) ;
  • Kim, Chang-Soo (Dept. of Radiological Science, College of Health Science, Catholic University of Pusan) ;
  • Kim, Jung-Hoon (Dept. of Radiological Science, College of Health Science, Catholic University of Pusan) ;
  • Kang, Se-Sik (Dept. of Radiological Science, College of Health Science, Catholic University of Pusan)
  • 백성민 (고신대학교 복음병원 핵의학과) ;
  • 고성진 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 김창수 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 김정훈 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 강세식 (부산가톨릭대학교 보건과학대학 방사선학과)
  • Received : 2010.07.13
  • Accepted : 2010.09.02
  • Published : 2010.09.30

Abstract

This study attempts to propose ways to optimize and improve the period of hospitalization for the radioiodine treatment by calculating the dose rate of patients treated with high-dose radioiodine by distance and time slot. As a result, 24 hours after the patient was treated with 100 mCi high-dose iodine, the dose rate was attenuated to $1,035{\mu}Sv/hr$ at the navel, to $109{\mu}Sv/hr$ at 50 cm, and to $33{\mu}Sv/hr$ at 100 cm. 24 hours after the patient was treated with 150 mCi high-dose iodine, the dose rate was attenuated to $637{\mu}Sv/hr$ at the navel, to $100{\mu}Sv/hr$ at 50 cm, and to $40{\mu}Sv/hr$ at 100 cm. 24 hours after the patient was treated with 180 mCi high-dose iodine, the dose rate was attenuated to $1,251{\mu}Sv/hr$ at the navel, $140{\mu}Sv/hr$ at 50 cm, and to $56{\mu}Sv/hr$ at 100 cm. In light of the current criterion for discharge recommended by the US Nuclear Regulatory Commission being $70.4{\mu}Sv/hr$, the present study indicates earlier discharge is feasible by applying a new scheme. This suggests that the proposed scheme in this study will help to solve the problem of shortage of treatment beds with the increasing trend of patients with thyroid cancer taken into consideration.

본 연구는 고용량 방사성옥소 치료환자의 선량률을 거리와 시간대별로 산출하여 방사성옥소 치료를 위한 입원기간의 최적화와 개선방안을 제한 하고자 하였다. 그 결과 100 mCi 고용량 옥소치료환자의 24시간 후에 배꼽에서 $1,035{\mu}Sv/hr$, 50 cm에서 $109{\mu}Sv/hr$, 100 cm에서 $33{\mu}Sv/hr$로 감쇠 되었다. 150 mCi 고용량 옥소치료환자의 24시간 후에 배꼽에서 $637{\mu}Sv/hr$, 50 cm에서 $100{\mu}Sv/hr$, 100 cm에서 $40{\mu}Sv/hr$로 감쇠 되었다. 180 mCi 고용량 옥소치료환자의 24시간 후에 배꼽에서 $1,251{\mu}Sv/hr$, 50 cm에서 $140{\mu}Sv/hr$, 100 cm에서 $56{\mu}Sv/hr$로 감쇠 되었다. 퇴원기준을 미국 원자력 규제위원회 고시에 $70.4{\mu}Sv/hr$이므로 본 연구 결과보다 빠른 퇴원이 가능하다. 치료 환자들의 계속적인 증가 추세로 볼 때 치료병실의 부족을 해소 할 수 있다.

Keywords

References

  1. 2006-2007년 암발생률, 1993-2007년 암발생자의 암생존율, 2007년 암유병률 통계, 보건복지가족부, 중앙암등록본부, 2009
  2. 윤국노, 임석태, 문은하, 김진숙, 정영진, 김동욱, 정환정, 손명희: 분화갑상선암으로 갑상선전절제술 후 고용량 방사성요오드 치료와 Helicobacter pylori감염과의 임상적 유용성, Nucl Med Mol Imaging, 43(6), 572-576, 2009
  3. 배상균: 갑상샘암의 방사성요오드 치료의 최신 지견, Nucl Med Mol Imaging, 40(2), 132-140, 2006
  4. Christoph R, Markus D, Markus K: Radio-iodine therapy in differentiated thyroid cancer: indications and procedures, Best Practice & Research Clinical Endocrinlolgy & Metabolism, 22(6), 989-1007, 2008 https://doi.org/10.1016/j.beem.2008.09.013
  5. International Commission on Radiological Protection: Radiation safety Aspects of Brachytherapy for Prostate Cancer using Permanently Implanted Source, ICRP Publication 98, Oxford OX5, UK, 2005
  6. 배상균: 갑상선 질환의 방사성옥소 치료, 대한핵의학회 연수강좌, 제 21차, 11-18, 2001
  7. 교육과학기술부고시 제 2009-37호, 2009
  8. 배기한, 김화중, 최재진, 이원국: 131I Therapy 입원환자의 선량률과 잔류량 및 배설률측정, 핵의학기술학회, 13(2), 47-52, 2009
  9. Mazzaferri E.L, Jhiang S.M: Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med, 97, 418-28, 1994 https://doi.org/10.1016/0002-9343(94)90321-2
  10. International Commission on Radiological Protection, "Individual Monitoring for Intakes of Radionuclides by Workers: Design and Interpretation," ICRP Publication 54, Pergamon Press, Oxford, UK, 1987
  11. 홍성운, 분화성: 갑상선암의 방사성옥소 치료, 대한핵의학회지, 34(4), 2000
  12. Harbert J.C: Nuclear Medicine Therapy. New York. Thieme Medical Publishers. 1987
  13. AJM van VELZEN, C.R. Chemaly, Radioisotope production capabilities, Therapeutic radioisotope usage in Europe Expected trends in terms of research activities, European Commission, EUR 21874 EN-DG JRC - Institute for Energy - RADIOISOTOPE SURVEY. 2005
  14. 고창순: 핵의학, 서울, 고려의학, 1997
  15. International Commission on Radiological Protection. Individual Monitoring for Intakes of Radionuclides by Workers: Design and Interpretation. Oxford: Pergamon Press; ICRP Publication 54, 1987
  16. International Commission on Radiological Protection, Age-dependent Doses to Members of the Public from Intake of Radionuclides, Part 2 Ingestion Dose Coefficients, ICRP Publication 67, Pergamon Press, Oxford, UK, 1993
  17. International Commission on Radiological Protection, Individual Monitoring for Internal Exposure of Workers Replecement of ICRP Publication 54, ICRP Publication 78, Pergamon Press, Oxford, UK, 1997
  18. Hurley J.R, Becker D.V: The use of radioiodine in the management of the tyroid cancer in freeman LM. Weissman HS. ed. Nuclear Medicine An-nual New York Raven Press, 329-84, 1983
  19. 이귀원: 고용량 방사성옥소(I-131) 치료환자의 피폭선량 저감화 연구, 방사선기술과학, 30(4), 435-442. 2007