Kang, Kyung Ok;Kim, Hyun Kyung;Kim, Ji Young;Lim, Seok Tae
Journal of East-West Nursing Research
/
v.22
no.2
/
pp.148-157
/
2016
Purpose: The purpose of this study was to explore the meaning of the experience of receiving radioactive iodine therapy among patients with thyroid cancer. Methods: A qualitative research design was adopted. The participants were ten women diagnosed with thyroid cancer who had received radioactive iodine therapy within one year. Data were collected through in-depth interviews from October of 2015 to April of 2016. Individual interviews were recorded, and transcribed data were analyzed using Colaizzi's method. Results: The six categories of the experience of receiving radioactive iodine therapy were "Finally realizing having cancer," "The lonely fight that feels like prison life," "Narrower scope of life," "Lack of understanding by others," "Enduring a short, yet difficult journey," and "A turning point for a new life." Conclusion: This study provides deep insight into the experience of thyroid cancer patients who had received radioactive iodine therapy. Nurses should concern their distress during radioactive iodine treatment and manage psychological difficulties as well as physical symptoms. Support from family and health care providers may help them to overcome the hard journey.
Radioactive iodine treatment has been widely used for nearly 50 years in the treatment of thyroid cancer to ablate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia is a rare complication associated with the radioactive iodine therapy. The occurrence of leukemia is known to be related to the cumulative dosage of I-131 more than 37 GBq (1 Ci) and also associated with the intervals of less than 12 months between the repeated doses. We report a case of a 52 year-old female patient with papillary cancer of thyroid who developed acute myelogenous leukemia after the total 20.4 GBq (550 mCi) of I-131 therapy over 3.2 years and palliative radiation therapy (3000 cGy) due to multiple bone metastasis of papillary cancer.
Purpose: To investigate the clinical manifestation of nasolacrimal duct obstruction after radioactive iodine therapy for thyroid cancer. Methods: The authors examined 622 patients who were treated with radioactive iodine therapy after the operation for thyroid cancer from January 2009 to December 2011. Fourteen patients (18 eyes) were diagnosed nasolacrimal duct obstruction based on the lacrimal irrigation test, lacrimal probing test and dacryocystography in our oculoplastic clinic. We analyzed the dose of radioactive iodine therapy, number of treatments, clinical manifestation and treatment type by retrospectively reviewing the patients' medical records. Results: The mean radioactive iodine dose ($215.7{\pm}23.1mCi$, p = 0.01) and the mean number of treatments ($1.36{\pm}0.50$, p < 0.001) were significantly greater in 14 patients who had nasolacrimal duct obstruction than in patients who did not. The average onset of tearing symptoms occurred 10.2 months after radioactive iodine therapy. The mean time between correct diagnosis and therapy was 18.4 months. Three patients (3 eyes) had occlusion at the common cannaliculus and 11 patients (15 eyes) had occlusion at the nasolacrimal duct. Ten patients (13 eyes) underwent endonasal dacryocystorhinostomy for complete obstruction and 4 patients (5 eyes) underwent silicone tube intubation for partial obstruction. Conclusions: Nasolacrimal duct obstruction is a rare complication associated with radioactive iodine therapy for thyroid cancer, thus, clinicians should be aware of this complication and refer patients with symptoms of epiphora to the oculoplastic department for specialized evaluation and treatment.
During the last several decades, prognosis of differentiated thvroid cancers improved markedly, mainly due to refinement of surgical techniques and routine use of radioactive iodine. Total or neat-total thyroidectomy is to be performed as the first line of treatment. Routine remnant ablation just after surgery decreases recurrence and increases survival. After then patients are maintained on suppressive dose of thyroid hormone to keep endogenous TSH below normal. Regular follow-up of the patients with serum thyroglobulin measurement and iodine whole body scan after thyroid hormone withdrawal or under recombinant human thyrotropin stimulation select high risk patients with recurrence or metastatic disease and treatment with therapeutic dose of radioactive iodine prolongs survival and sometimes leads cure. Currently recommended diagnostic and therapeutic strategies, present controversies and future directions are discussed.
Background : For biological dosimetry of radiation exposure, both observing hematologic change and calculating Ydr by chromosomal analysis as biological indicators are widely used. However, due to the lack of studies on biological dosimetry of radiation dose absorbed in the body such as in the cases of radioactive iodine therapy, the maximal and safe dose is not well known, nor is the extent to which the body can safely endure radiation exposure. Purpose : To investegate the practical applicability of hematologic changes and Ydr as an indicator for estimating radiation exposure, to patients with thyroid diseases after doses of radioactive iodine. Material and Methods : 5 patients with hyperthyroidism and 35 patients who have had thyroid cancer operation were under treatment with radioactive iodine, changes in number of lymphocytes were tracked and Ydr was calculated for more than 2 months by chromosomal analysis in peripheral lymphocytes. Results ; 1) The number of lymphocytes began to decrease 2 weeks after doses of radioactive iodine, and reached the nadir after 6 and 8 weeks, then gradually recovered. 2) The nadir count of lymphocytes was reversely correlated with the administered dosage of radioactive iodine. 3) Ydr was generally stable between 2 and 8 weeks. 4) The maximal value of Ydr was correlated with the administered dosage of radioactive iodine. 5) Ydr value at the 2nd week increased with augmented dosage of radioactive iodine. 6) Ydr value at the 2nd week was correlated with fall of lymphocyte count. Conclusion : Patients must be closely observed, because temporary bone marrow suppression and slight chromosomal aberration can be produced by even generally used dosages of radioactive iodine for diagnosis and therapy. Maximal percent fall of lymphocyte count, Ydr at the 2 week interval and maximal Ydr can be used as the biological predictor of administered dosage of radioactive iodine.
Kim, Gi-sub;Jung, Haijo;Park, Min-seok;Jeon, Gjin-seong
The Korean Journal of Nuclear Medicine Technology
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v.17
no.1
/
pp.3-6
/
2013
Purpose: The treatment of thyroid cancer patients was continuously increased. According to the increment of thyroid cancer patients, the establishment of iodine therapy site was also increased in each hospital. This treatment involves the administration of radioactive iodine, which will be given in the form of a capsule. Therefore, protections and managements for radioactive source pollution and radiation exposure should be necessary for radiation safety. Among the many problems, the problem of disposing the radioactive wastes was occurred. In this study, The date for self-disposal for radioactive wastes, which were contaminated in clothes, bedclothes and trash, were calculated. Materials and Methods: The number of iodine therapy ward was 15 in Korea Institute of Radiological Medical and Sciences. Recently, 8 therapy wards were operated for iodine therapy patients and others were on standby for emergency treatment ward of any radiation accidents. Radioactive wastes, which were occurred in therapy ward, were clothes, bedclothes, bath cover for patients washing water and food and drink which was leftover by patients. Each sample was hold into the marinelli beaker (clothes, bedclothes, bath covers) and 90 ml beaker (food, drink, and washing water). The activities of collected samples were measured by HpGe MCA device (Multi Channel Analysis, CANBERRA, USA) Results: The storage period for the each kind of radioactive wastes was calculated by equation of storage periods based on the measurement outcomes. The average storage period was 60 days for the case of clothes, and the maximum storage period was 93 days for patient bottoms. The average storage period and the maximum storage period for the trash were 69 days and 97 days, respectively. The leftover foods and drinks had short storage period (the average storage period was 25 days and maximum storage period was 39 days), compared with other wastes. Conclusion: The proper storage period for disposing the radioactive waste (clothes, bedclothes and bath cover) was 100 days by the regulation on self-disposal of radioactive waste. In addition, the storage period for disposing the liquid radioactive waste was 120 days. The current regulation for radioactive waste self-disposing was not suitable for the circumstances of each radioactive therapy facility. Therefore, it was necessary to reduce the leftover food and drinks by adequate table setting for patients, and improve the process and regulation for disposing the short-half life radioactive wastes.
Radioactive iodine (131I) released from nuclear power plants has been a critical environmental concern for workers. The effective trapping of radioactive iodine isotopes from the off-gas stream generated from nuclear facilities is an important issue in radioactive waste treatment systems evaluation. Numerous studies on retaining methyl iodide (CH3I131) by impregnated activated carbons under the high content of moisture have been extensively studied so far. But there have been no good results on how to remove methyl iodide at high humid conditions up to now. A new challenge is to introduce other promising impregnating chemical agents that are able to uptake enough radioactive methyl iodide under high humid conditions. In order to develop a good removal efficiency to control radioiodine gas generated from a high humid process, activated carbons (ACs) impregnated with triethylene diamine (TEDA) and qinuclidine (QUID) were prepared. In addition, the removal efficiencies of the activated carbons (ACs) under humid conditions up to 95% RH were evaluated by applying the standard method specified in ASTM-D3808. Quinuclidine impregnated activated carbon showed a much higher decontamination factor above 1,000, which is enough to meet the regulation index for the iodine filters in nuclear power plants (NPPs).
Park Yoon-Kyu;Lee Dae-Young;Chon Seong-Eun;Oh Sung-Soo;Chung Eul-Sam
Korean Journal of Head & Neck Oncology
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v.12
no.1
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pp.32-42
/
1996
This study was desinged to evaluate the effect of radioactive iodine-131 therapy in differentiated thyroid carcinoma treated at the Presbyterian Medical Center, Chonju during the 20-year period from 1975 to 1994. The authors reviewed 246 patients who received radioactive iodine-131. An analysis of the therapeutic response and survival rates of the 246 patients has been carried out. The male to female ratio was 1 : 3.6. The peak incidence was in the 4th and 6th decades. The histologic findings in the 246 patients were papillary adenocarcinoma in 200 cases, follicular adenocarcinoma in 29 cases, mixed type in 14 cases, and others in 3 cases. Combined treatment modalities of 246 patients consisted of sugery and radioiodine in 222 cases, surgery with radioiodine and external irradiation in 11 cases, and surgery with radioiodine, external irradiation and chemotherapy in 5 cases. 42 of the 246 cases showed recurrence and the commonest type of combined treatment for recurrent case was surgery followed by radioiodine-131. The highest accumulated total dosage of radioiodine-131 was 480mCi in that case femoral metastasis was noticed. The most common locoregional metastatic site was ipsilateral cervical node, and neighbouring muscle, vessel, trachea, recurrent layngeal nerve, in order of frequency. The determinate 10-year survival rate was 91.8% in the group receiving surgery followed by radioiodine-13l and 71.4% in patients receiving surgery, radioiodine-13l with XRT. The determinate 10-year survival rate was better for patients under 40 years of age who received radioiodine as compared to patients over 40 year of age(85.7% vs. 33.3%). The most usual primary therapeutic dosage in the group of cervical lesion was 90$\sim$120mCi after surgery.
A low iodine diet (LID) is the recommended preparation for radioactive iodine treatment. However, the recommended duration and stringency of LID are different among each recommendation. More stringent LID is expected in Korea because Korea is a iodine-rich region. We investigated the decrement of urine iodine excretion by two-week stringent LID for remnant thyroid ablation with radioactive iodine in Korean patients with thyroid cancer, prospectively. Material and Method: From November 2006, patients who referred to our hospital for remnant ablation after total thyroidectomy were included in this study. To decrease total body iodine, our protocol included three strategies. First, we checked medication which could inhibit the radioactive iodine uptake. Second, the date of 1-131 treatment was scheduled at least 3 months later if contrast agent had been used. The last strategy was two-week stringent LID education by specialized nutritionist. Before and after two-week stringent LID, 24hr-urine iodine was analyzed respectively. 24hr-urine creatinine was also analyzed for determining more valid 24hr urine sampling subgroup. Results: Total 51 patients were finally enrolled. Average of 24hr-urine iodine excretion was significantly lowered ($787{\pm}2242\;{\rightarrow}\;85{\pm}85\;{\mu}g/d$, p=0.03) after LID and 74.4% of patients reached below the recommended urine iodine excretion level ($<100\;{\mu}g/d$). In subgroup (n=14), similar results was showed ($505{\pm}666\;{\rightarrow}\;99{\pm}116\;{\mu}g/d$, p=0.05) and 78.6% of patients met the criteria. Conclusion: Most patients could reach below the recommended urine iodine level after two-week stringent LID. Therefore, in our opinion, at least two-week stringent LID should be recommended in Korea.
Many radionuclides exist in normal environment and artificial radionuclides also can be detected. The radionuclides ($^{131}I$) are widely used for labeling compounds and radiation therapy. In Korea, the radionuclide ($^{131}I$) is produced at the Radioisotope Production Facility (RIPF) at the Korea Atomic Energy Research Institute in Daejeon. The residents around the RIPF assume that $^{131}I$ detected in environmental samples is produced from RIPF. To ensure the safety of the residents, the radioactive concentration of $^{131}I$ near the RIPF was investigated by monitoring environmental samples along the Gap River. The selected geographical places are near the nuclear installation, another possible location for $^{131}I$ detection, and downstream of the Gap River. The first selected places are the "front gate of KAERI", and the "Donghwa bridge". The second selected place is the sewage treatment plant. Therefore, the Wonchon bridge is selected for the upstream of the plant and the sewage treatment plant is selected for the downstream of the plant. The last selected places are the downstream where the two paths converged, which is Yongshin bridge (in front of the cogeneration plant). In these places, environmental samples, including sediment, fish, surface water, and aquatic plants, were collected. In this study, the radioactive iodine ($^{131}I$) detection along the Gap River will be investigated.
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