Less-restrictive, patient-specific radiation safety precautions can be safely prescribed after permanent seed implantation Journal Article

   

Authors:	Dauer, L. T.; Kollmeier, M. A.; Williamson, M. J.; St. Germain, J.; Altamirano, J.; Yamada, Y.; Zelefsky, M. J.
Article Title:	Less-restrictive, patient-specific radiation safety precautions can be safely prescribed after permanent seed implantation
Abstract:	Purpose: To use radiation exposure rate measurements to determine patient-specific radiation safety instructions with the aim of reducing unnecessary precaution times and to evaluate potential doses to members of the public. Methods and Materials: Radiation exposure rate measurements were obtained from 1279 patients with Stage T1-2 prostate cancer who underwent transperineal 125I or 103Pd seed implantation from January 1995 through July 2008. An algorithm was developed from these measurements to determine the required precaution times to maintain public effective doses below 50% of the limits for specific exposure situations. Results: The median air kerma rates at 30 cm from the anterior skin surface were 4.9 μGy/h (range: 0.1-31.5) for 125I and 1.5 μGy/h (range: 0.02-14.9) for 103Pd. The derived algorithms depended primarily on the half-life Tp, the measured exposure rate at 30 cm, and specific exposure situation factors. For the typical 103Pd patient, no radiation safety precautions are required. For the typical 125I patient, no precautions are required for coworkers, nonpregnant adults who do not sleep with the patient, or nonpregnant adults who sleep with the patient. Typical 125I patients should only avoid sleeping in the "spoon" position (i.e., in contact) with pregnant adults and avoid holding a child for long periods of time in the lap for about 2 months. Conclusions: The large number of cases available for this study permitted the development of an algorithm to simply determine patient-specific radiation safety instructions. The resulting precaution times are significantly less restrictive than those generally prescribed currently. © 2010 American Brachytherapy Society.
Keywords:	adult; aged; aged, 80 and over; middle aged; major clinical study; cancer radiotherapy; radiation dose; radiotherapy dosage; prevalence; radiation exposure; prostate cancer; prostatic neoplasms; iodine 125; algorithm; skin surface; patient safety; radiation injuries; brachytherapy; radiometry; relative biological effectiveness; radiation safety; body burden; new york; radioisotopes; palladium 103; radiation protection; 103pd; 125i; dose rate; family members; precautions; public; seed; sleep
Journal Title:	Brachytherapy
Volume:	9
Issue:	2
ISSN:	1538-4721
Publisher:	Elsevier Science, Inc.
Date Published:	2010-04-01
Start Page:	101
End Page:	111
Language:	English
DOI:	10.1016/j.brachy.2009.06.006
PUBMED:	19853532
PROVIDER:	scopus
PMCID:	PMC3819139
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-77949642053&partnerID=40&md5=980904683ee68b6066e6597e49371393
Notes:	--- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: BRACC" - "Source: Scopus"

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