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Outpatient Radioablation Therapy for Thyroid Cancer Patients with Minimal Radiation Exposure to the Family Members  

Park, Hee-Myung (Myongji Hospital, School of Medicine, Kwandong University)
Jang, Jung-Woong (Myongji Hospital, School of Medicine, Kwandong University)
Yang, Hee-Chul (Myongji Hospital, School of Medicine, Kwandong University)
Kim, Young-Gook (Myongji Hospital, School of Medicine, Kwandong University)
Publication Information
Nuclear Medicine and Molecular Imaging / v.41, no.3, 2007 , pp. 218-225 More about this Journal
Abstract
Purpose: Postoperative thyroid remnant radioablation therapy is necessary to reduce the recurrence and mortality rates as well as to prepare the patients for a proper long term surveillance of well-differentiated thyroid cancers. The radiation safety rules of the government require the patient to be isolated in a hospital if the expected radiation exposure to the family members would be greater than 5 mSv (500 mRem). The purpose was to measure the radiation received by the family members of patients who received large doses of NaI-131. Material and Methods: We have administered 12 therapy doses ranging from 3.70-5.55 GBq (100 to 150 mCi) to 11 patients, and released them immediately if they met the radiation safety criteria. Informed consent was obtained from the subjects prior to the therapy, and each of them agreed to follow written radiation safety instructions. TLD badges were used to measure the radiation dose received by the family members and the room adjacent to the patient's bed room during the first 72 hours. Results: The average dose received by the family members who spent the most time in the closest distance with the patients was 0.04 mSv with a range of 0.01-0.17 mSv. Even the highest dose was only about 3% of the limit set by the government. The average radiation dose to the outer wall of the patient's room was 0.15 mSv. Conclusion: It is concluded that I-131 ablation therapy can be administered to outpatients safely to thyroid cancer patients who meet the established radiation safety criteria and follow the instructions.
Keywords
thyroid cancer; radioablation; radiation exposure; outpatient therapy;
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1 Shah MD, Hall FT, Eski SJ, Witterick IJ, Walfish PG, Freeman JL Clinical course of thyroid carcinoma after neck dissection. Laryngoscope 2003;113:2102-07   DOI   ScienceOn
2 Samaan NA, Schultz PN, Hickey RC, Goepfert H, Haynie TP, Johnson DA, et al. The results of various modalities of treatment of well differentiated thyroid carcinomas: A retrospective review of 1599 patients. J Clin Endocrinol Metab 1992;75:714-20   DOI
3 Thyroid Carcinoma. Version 1. 2003. Clinical Practice Guidelines in Oncology - National Comprehensive Cancer Network, 2003
4 U.S. Nuclear Regulatory Commission's Regulatory Guide 8.39 Release of patients administered radioactive materials. April 1997. Available from: URL: http://www.nrc.gov/electronic reading room/ regulatory guides/regulatory guides (by division)/occupational health (8)/8.39 ML003739575
5 Bourguignon MH. The potential impact of radiation biology in radiation protection in nuclear medicine and corresponding regulatory issues. Proceedings of the 9th congress of world federation of nuclear medicine and biology, Seoul, Korea. 22-27 Oct., 2006. World J Nucl Med 2006;5:362-64
6 Hickey RJ, Bowers EJ, Spence DE, Zemel BS, Clelland AB, Clelland RC. Low level ionizing radiation and human mortality: Multi-regional epidemiological studies. Health Phys 1981;40:625-41   DOI   ScienceOn
7 Sanders CL, Sohn S. Evidence for radiation hormesis from epidemiological studies of cancer. Proceedings of the 9th congress of world federation of nuclear medicine and biology, Seoul, Korea. 22-27 Oct., 2006. World J Nucl Med 2006;5:258-60
8 Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 1994;97:418-28   DOI   ScienceOn
9 Questionnairs for occupancy factor (Table 1) and contamination factor (Table 2), and maximum Permissible I-131 Dose (Table 3): Developed and calculated using the NRC guide 8.39 by the Radiation Safety Office, Indiana University, Indianapolis, Indiana
10 Department of science and technology, Korea: Announcement No.2005-35, section 12. Isolation of patients. 과학기술부 고시 제 2005-35-제12조 환자격리. Available at 한국 원자력 안전기술원. Available from: URL: http://www.kins.re.kr /원자력관계법령/ 과학 기술부고시/방사선 010/46조/12조
11 Venencia CD, Germanier AG, Bustos SR, Giovannini AA, Wyse EP. Hospital discharge of patients with thyroid carcinoma treated with I-131. J Nucl Med 2005;43:61-5
12 Culver CM, Dworkin HJ. Radiation safety considerations for post-iodine-131 hyperthyroid therapy. J Nucl Med. 1991;32:169-73
13 Grigsby PW, Siegel BA, Baker S, Eichling JO. Radiation exposure from outpatient radioactive iodine therapy for thyroid carcinoma. JAMA 2000;283:2272-4   DOI   ScienceOn
14 Department of science and technology, Korea: Announcement No.2005-35, sections 13 and 46: Discharging patient excreta from medical facility. 과학기술부 고시 제 2005-35, 46조, 13조 (의료기 관의 진료환자 배설물). Available at 한국 원자력 안전기술원. Available from: URL:http://www.kins.re.kr/원자력관계법령/과학기 술부고시/방사선 010/46조/13조
15 Pacini F, Ladenson PW, Schlumberger M, Driedger A, et al. Radioiodine Ablation of Thyroid Remnants after Preparation with Recombinant Human Thyrotropin in Differentiated Thyroid Carcinoma: Results of an International, Randomized, Controlled Study. J Clin Endocrinol Metab 2005;91:926-32   DOI
16 DeGroot LJ, Kaplan EL, McCormick M, Straus FH. Natural history, treatment, and course of papillary thyroid carcinoma. J Clin Endocrinol Metab 1990;71:414-24   DOI
17 Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2006;16:109-42   DOI