Exposure of Treating Physician to Radiation during Prostate Brachytherapy Using Iodine-125 Seeds

Schiefer, Hans; Toggenburg, Friedrich von; Seelentag, W; Plaßwilm, Ludwig; Ries, Gerhard; Lenggenhager, C.; Schmid, Hans‐Peter; Leippold, Thomas; Prikler, Ladislav; Krusche, B.; Roth, Jakob; Engeler, Daniel S.

doi:10.1007/s00066-009-1990-z

Cited by 11 publications

(8 citation statements)

References 23 publications

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“…Unfortunately there was no reported adjustment for age. In relation to occupational exposure to radiation in treating physicians (Schiefer et al, 2009) in the seeding of the prostate, the cumulative effect of treatment applications on the physician was such that experienced physicians could undertake 400 applications per year without exceeding the threshold value, but inexperienced physicians could only safely undertake 200 applications per year. This study had too small a sample to give more definitive associations regarding prostate cancer and occupational radiation exposure in the physicians themselves.…”

Section: Physical and Environmental Factorsmentioning

confidence: 99%

An Update on Occupation and Prostate Cancer

Doolan¹,

Benke²,

Giles³

2014

Asian Pacific Journal of Cancer Prevention

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Background: Our aim was to identify gaps and limitations in the current literature and to make recommendations for future research required to address these. Materials and Methods: We reviewed occupational exposures and related factors associated with the risk of prostate cancer between 2000 and 2012. These included chemical, ergonomic, physical or environmental, and psychosocial factors which have been reported by epidemiological studies across a range of industries. Results: The results are inconsistent from study to study and generally this is due to the reliance upon the retrospectivity of case-control studies and prevalence (ecological) studies. Exposure assessment bias is a recurring limitation of many of the studies in this review. Conclusions: We consider there is insufficient evidence to implicate prostate cancer risk for ergonomic, physical, environmental or psychosocial factors, but there is sufficient evidence to implicate toxic metals, polychlorinated biphenyls (PCBs) and polycyclic aromatic hydrocarbons (PAHs). More research is required to identify specific pesticides that may be associated with risk of prostate cancer.

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Section: Physical and Environmental Factorsmentioning

confidence: 99%

An Update on Occupation and Prostate Cancer

Doolan¹,

Benke²,

Giles³

2014

Asian Pacific Journal of Cancer Prevention

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“…It is estimated that more than 50,000 patients with clinically localized prostate cancer are treated with 125 I or 103 Pd seeds every year worldwide and this number is anticipated to increase in the near future [1,4,6,9,11,[14][15][16][17]21]. Furthermore, stereotactically guided interstitial therapy with 125 I is an established and important therapeutic option in the treatment of gliomas and brain metastases [19,20].…”

Section: Introductionmentioning

confidence: 99%

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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“…In contrast, less data is available about radiation exposure to personnel performing the implant [ 17 ]. When such information is discussed in the literature, it is usually limited and involves one site of interest, such as the eye or hand [ 18 , 19 ]. Despite this, even fewer articles discuss techniques or materials that can help reduce exposure to the medical staff performing the implant.…”

Section: Purposementioning

confidence: 99%

Original paper A novel perineal shield for low-dose-rate prostate brachytherapy

Weiner¹,

Schwartz²,

Safdieh³

et al. 2015

jcb

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PurposeTo study the impact on radiation exposure to staff through the use of an original perineal shield during low-dose-rate prostate brachytherapy.Material and methodsWe designed a 1 mm thick stainless steel shield that duplicates and is able to slide directly over a standard commercialized prostate brachytherapy grid. We then analyzed the post-procedure exposure in 15 consecutive patients who underwent Iodine-125 seed placement. Measurements were performed with and without the shield in place at fixed locations relative to the grid template. Endpoints were analyzed using the paired two-sample t-test, with statistical significance defined as a p-value < 0.05.ResultsThe exposure at the midline grid template ranged from 0.144-0.768 mSv/hr without the shield, and 0.038-0.144 mSv/hr with the shield (p < 0.0001). The exposure 10 cm left of the grid template was 0.134-0.576 mSv/hr without the shield, and 0.001-0.012 mSv/hr with the shield (p < 0.0001). The exposure 10 cm right of the grid template was 0.125-0.576 mSv/hr without the shield, and 0.001-0.012 mSv/hr with the shield (p < 0.0001). The median reduction of exposure at the grid was 76% midline, 98.5% left, and 99% right. Similarly, each individual dose rate was recorded at 25 cm from the perineum, both with and without shield. The median reduction of exposure 25 cm from the perineum was 73.7% midline, 77.7% left and 81.6% right (p < 0.0001).ConclusionsOur novel shield took seconds to install and was non-restrictive during the procedure, and provided at least a four-fold reduction in radiation exposure to the brachytherapist.

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Exposure of Treating Physician to Radiation during Prostate Brachytherapy Using Iodine-125 Seeds

Cited by 11 publications

References 23 publications

An Update on Occupation and Prostate Cancer

An Update on Occupation and Prostate Cancer

Radiation Protection of Persons Living Close to Patients with Radioactive Implants

Original paper A novel perineal shield for low-dose-rate prostate brachytherapy

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