Schwartz David J, Davis Brian J, Vetter Richard J, Pisansky Thomas M, Herman Michael G, Wilson Torrence M, LaJoie Wayne N, Oberg Ann L
Division of Radiation Oncology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
Brachytherapy. 2003;2(2):98-102. doi: 10.1016/S1538-4721(03)00097-7.
To identify factors associated with radiation exposure (RE) to operating room personnel during transperineal interstitial permanent prostate brachytherapy (TIPPB).
Between May 1998 and December 2000, 155 patients underwent TIPPB with fluoroscopic and ultrasound guidance. Data for each case included: operating room time (OT), anesthesia time (AT), fluoroscopy time (FT), number and type of seed implanted, total seed activity, and resident participation.
Personnel RE per case, FT, OT, and AT decreased as case number increased. Whole body badge dose per case decreased from a mean of 0.15+/-0.01 mSv (15+/-1 mrem) in 1998 to 0.074+/-0.011 mSv (7+/-1 mrem) in 2000. Average FT per case decreased from a mean of 17:27 min (range, 10:40-28:23) in 1998 to 12:08 min (range, 6:40-31:00) in 2000. Resident participation was associated with increased FT. Mean whole body and ring badge doses for the treating radiation oncologist were 0.0076 mSv/min (0.76 mrem/min) and 0.05 mSv/min (5.26 mrem/min) of FT, respectively.
FT was the predominant factor that related to RE during TIPPB. Treating radiation oncologists were exposed to less than 20 mSv per 100 cases, significantly less than other fluoroscopically guided procedures. Nonetheless, appropriate radiation exposure precautions during TIPPB should continue.
确定经会阴间质永久性前列腺近距离放射治疗(TIPPB)期间与手术室人员辐射暴露(RE)相关的因素。
1998年5月至2000年12月期间,155例患者在荧光镜和超声引导下接受了TIPPB。每个病例的数据包括:手术室时间(OT)、麻醉时间(AT)、荧光镜检查时间(FT)、植入种子的数量和类型、种子总活度以及住院医师参与情况。
随着病例数增加,每例的人员RE、FT、OT和AT均下降。每例的全身徽章剂量从1998年的平均0.15±0.01 mSv(15±1 mrem)降至2000年的0.074±0.011 mSv(7±1 mrem)。每例的平均FT从1998年的平均17:27分钟(范围10:40 - 28:23)降至2000年的12:08分钟(范围6:40 - 31:00)。住院医师参与与FT增加相关。治疗放射肿瘤学家的平均全身和戒指徽章剂量分别为每FT分钟0.0076 mSv(0.76 mrem/min)和0.05 mSv/min(5.26 mrem/min)。
FT是TIPPB期间与RE相关的主要因素。治疗放射肿瘤学家每100例暴露剂量低于20 mSv,明显低于其他荧光镜引导的手术。尽管如此,TIPPB期间仍应继续采取适当的辐射暴露预防措施。