Assessment of radiation safety instructions to patients based on measured dose rates following prostate brachytherapy

Dauer, Lawrence T.; Zeléfsky, Michael J.; Horan, Christopher; Yamada, Yoshiya; Germain, Jean St.

doi:10.1016/j.brachy.2004.02.002

Cited by 24 publications

(16 citation statements)

References 4 publications

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“…Now some publications are available which provide interesting and important data on radiation protection for 125 I and 103 Pd permanent implants. These data [2,3,6,8,10,18] support the conclusion that patients treated with these implants do not represent a radiation risk to members of the public. As regards family members and close friends or carers, it must be taken into account, however, that for these persons there may result dose rate values -due to smaller distances and considerably longer periods of contact -that lead to radiation exposures exceeding, e.g., 1 mSv per calendar year [2,7,8].…”

Section: Methodssupporting

confidence: 71%

Radiation Protection of Persons Living Close to Patients with Radioactive Implants

Kaulich¹,

Bamberg²

2010

Strahlenther Onkol

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Background: Permanent interstitial brachytherapy is -in certain cases -a very successful therapeutic option, but application of radioactive implants always results in only gradually diminishing radiation exposure of persons in the patient's immediate surroundings. Material and Methods: Using patients with clinically localized prostate cancer treated with iodine-125 ( 125 I) or palladium-103 ( 103 Pd) as an example, it is shown how a patient, if necessary or wished by him, can, by wearing commercially available X-ray protection shorts, reduce radiation exposure of family members in such a way that at a distance r from the patient a given dose per year is not exceeded. Results: The computational procedures necessary for the determination of the individual periods of wearing X-ray protection clothing are provided in the form of formulae and graphics. All considerations and calculations can also be applied to other radiotherapeutic interventions involving the use of 125 I, 103 Pd or other γ-sources. Conclusion: If necessary, a patient with permanent radioactive implants can reduce radiation exposure of family members by wearing special X-ray protection clothing for a limited period of time. This kind of radiation protection is very efficient and considerably simpler to accomplish than a reduction of exposure time or an increase of the distance between the patient and family members. Strahlenschutz von Personen, die mit Patienten mit radioaktiven Implantaten zusammenlebenHintergrund: Die permanente interstitielle Brachytherapie ist eine sehr erfolgreiche therapeutische Option, die aber immer auch mit einer Strahlenexposition von Personen in unmittelbarer Umgebung des Patienten verbunden ist. Material and Methodik: Am Beispiel von Patienten mit Prostatakarzinom, die mit Jod-125 ( 125 I) oder Palladium-103 ( 103 Pd) behandelt wurden, wird gezeigt, wie der Patient durch individuell begrenzte Tragedauer kommerziell erhältlicher Strahlenschutzhosen die Strahlenexposition seiner Familienmitglieder, falls erforderlich oder von ihm gewünscht, so limitieren kann, dass im Abstand r vom Patienten eine vorgegebene Dosis pro Jahr nicht überschritten wird. Ergebnisse: Die benötigten Berechnungsgrundlagen werden als Formeln und Grafiken zur Bestimmung der individuellen Tragedauer der Strahlenschutzhosen präsentiert. Alle Überlegungen und Berechnungen lassen sich auch auf andere strahlentherapeutische Maßnahmen mit 125 I, 103 Pd oder auch andere γ-Strahler anwenden. Schlussfolgerung: Ein Patient mit radioaktivem Permanentimplantat kann durch das zeitlich begrenzte Tragen von Strahlenschutzhosen die Strahlenexposition von Familienmitgliedern stark reduzieren. Diese Strahlenschutzmaßnahme ist sehr wirkungsvoll und wesentlich einfacher anzuwenden als eine Reduktion der Aufenthaltsdauer oder eine Vergrößerung des Abstands zu Familienmitgliedern. Schlüsselwörter: Brachytherapie · Seedimplantation · 125 I · 103 Pd · Strahlenschutz IntroductionThe use of radioactive implants (iodine-125 [ 125 I] or palladium-103 [ 103 Pd] seeds) has been in...

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Section: Methodssupporting

confidence: 71%

Radiation Protection of Persons Living Close to Patients with Radioactive Implants

Kaulich¹,

Bamberg²

2010

Strahlenther Onkol

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“…The safety of LDR prostate brachytherapy has been investigated in several studies (13)(14)(15), and the radiation dose emitted from the implanted seeds was shown to be negligible as far as exposure of the general public to radiation was a concern (13,14). Applying the current NRC tissue-weighting factor of 0.25 for the gonads (as a surrogate for penile tissues) to the 5 mSv, the whole body effective dose limit, results in an equivalent organ dose limit for the penile tissue of 20 mGy (2 cGy).…”

Section: Discussionmentioning

confidence: 99%

Radiation Safety of Receptive Anal Intercourse with Prostate Cancer Patients Treated with Low-Dose-Rate Brachytherapy

et al. 2016

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PURPOSE-Prostate low-dose-rate (LDR) brachytherapy involves implantation of radioactive seeds permanently into the prostate gland. During receptive anal intercourse, the penis of the partner may come in close proximity to the implanted prostate gland. We estimate the potential intrarectal dose rates and suggest guidance on radiation precautions.METHODS AND MATERIALS-One hundred two patients were included in the study. After implantation, with patients under anesthesia in the dorsal lithotomy position, a new set of ultrasound (US) images and a CT scan were obtained. The images were fused, radioactive seeds and US probe locations were determined on the CT, and prostate, bladder, and rectal contours were drawn on the US. Dose rates (cGy/h) were calculated for the portion of the US probe spanning the prostate for several dose-volume histogram parameters.RESULTS-Twenty patients were treated with 125 I and 82 patients with 103 Pd. Average dose rates at Day 0 to the portion of the US probe spanning the prostate were 2.1 ± 1.3 cGy/h and 2.5 ± 0.8 cGy/h for patients treated with 125 I and 103 Pd, respectively. After 60 days, average calculated probe dose drops to 1.0 ± 0.6 cGy/h and 0.2 ± 0.1 cGy/h for 125 I and 103 Pd, respectively. CONCLUSIONS-During the immediate weeks after prostate seed implant, the estimated intrarectal dose rates are higher in 103 Pd compared to 125 I. As 103 Pd decays faster than 125 I, 2 months after the implant, radiation exposure from 103 Pd becomes lower than 125 I. Receptive anal intercourse time should be kept as low as possible during 2 and 6 months after low-dose-rate brachytherapy of the prostate with 103 Pd and 125 I, respectively.

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“…Published data from direct dose measurements from patients differ by more than a factor of 10 and show a large variation. In this report data from MSKCC [84] of a person present in the isotropic beam of radiation at some distance from the patient, a conversion factor of 0.05 Sv/Gy is handled [85].…”

Section: A3 Safety Aspectsmentioning

confidence: 99%

NCS Report 20: Dosimetry and quality control of brachytherapy with low-energy photon sources (I-125)

Aalbers¹,

Brabandere²,

Koedooder³

et al. 2012

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Assessment of radiation safety instructions to patients based on measured dose rates following prostate brachytherapy

Cited by 24 publications

References 4 publications

Radiation Protection of Persons Living Close to Patients with Radioactive Implants

Radiation Protection of Persons Living Close to Patients with Radioactive Implants

Radiation Safety of Receptive Anal Intercourse with Prostate Cancer Patients Treated with Low-Dose-Rate Brachytherapy

NCS Report 20: Dosimetry and quality control of brachytherapy with low-energy photon sources (I-125)

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