Radiation exposure to caregivers from patients undergoing common radionuclide therapies: a review

Abstract

The contribution of radionuclide therapies (RNTs) to effective patient treatment is widely appreciated. The administration of high doses has necessitated investigating the potential radiation hazard to caregivers from patients undergoing RNTs. This work aimed to review the literature regarding measured effective doses to caregivers from such patients. The main selection criterion was the presence of real radiation exposure measurements. The results were categorised according to the treatment protocol and dose parameters. Analysis of the collected data demonstrated that the measured effective dose values were within the dose constraints defined by the International Commission on Radiological Protection, provided that the radiation protection instructions were followed by both patients and caregivers. In conclusion, the radiation risk for caregivers was almost negligible. In this context, treatments could be administered more often on an outpatient basis, once cost-effectiveness criteria were established and radiation protection training and procedures were appropriately applied.

Radiation safety considerations for the use of radium-224-calciumcarbonate-microparticles in patients with peritoneal metastasis

“…While other radionuclides have been studied for treating peritoneal metastasis with origin from ovarian cancer, such as 90 Y-HMFG1 and 211 At-MX35-F(ab’) 2 being two of the candidates ( 11 , 12 ), we have not been able to find radiation protection publications related to these treatments. Stefanoyiannis et al ( 13 ) compared studies examining radiation exposure to caregivers from patients for different common radionuclide therapies. These included radiopharmaceuticals with iodine-131 ( 131 I), yttrium-90 ( 90 Y) and lutetium-177 ( 177 Lu).…”

“…Although amounts of activity should not be directly compared in most circumstances, it is worth mentioning that in the case of 224 Ra-CaCO 3 -MP, an activity of three or four orders of magnitude lower (7 MBq) is used. In summary, Stefanoyiannis et al found that the doses was within the dose constraints of 5 mSv to home caregivers, recommended by the International Commission of Radiological Protection (ICRP)(13). They also highlighted the importance of giving specific instructions to caregivers, as the highest dose values were found when no instructions were given.The standard activity dosage of 223 RaCl 2 is 55 MBq/kg body weight given intravenously in six administrations 4 weeks apart(14).…”

Do Current Radiation Safety Guidelines allow the Safe Release of a Thyroid Cancer Patient after High-dose Radioiodine Therapy? An Indian Perspective

“…[ 12 ] Outpatient-based remnant thyroid ablation with I-131 (1,110 MBq) performed in patients with DTC could be a safe alternative if applied under experts' appropriate supervision and guidance. [ 9 10 ] Despite poor compliance with safety guidelines, a short-stay protocol respects current legislation and applies to most patients treated with 3.7 GBq. [ 19 ] Higher body weight and distant metastases may predict higher radiation exposure from patients after RAI therapy.…”

“…An outpatient treatment results in a minimal dose to the family members if the patient's families could comply with statutory dose limits and restrictions. [ 8 9 10 11 ] It could be more cost effective and has better patient acceptance. [ 12 ]…”

Determination of Radiation Exposure of Individuals in the Population by Patients after Radioiodine Therapy – Comparison of two Measurement Systems

“…This result concurs with the literature. Data were provided on the effect of various radionuclide therapies on the exposure of relatives [16], ranging from 0.1-3.08 mSv. In another study by Matheud et al [17] similar effective doses for relatives and other groups of people (employees, traveling companions) are listed, the range is given as 0.3 mSv to 3 mSv.…”