Rimpler A, Barth I, Baum R B, Senftleben S, Geworski L
Bundesamt für Strahlenschutz (BfS), Köpenicker Allee 120-130, 10312 Berlin, Germany.
Radiat Prot Dosimetry. 2008;131(1):73-9. doi: 10.1093/rpd/ncn224. Epub 2008 Aug 21.
Radioimmunotherapies (RITs) and peptide receptor radiotherapies (PRRTs) with (90)Y-labelled compounds offer promising prospects for tumor treatment in nuclear medicine. However, when preparing and performing these therapies, which require manipulations of high activities of (90)Y (>1 GBq), technicians and physicians may receive high exposures, mainly to the skin of the hands. Even non-occupationally exposed persons, such as caregivers and family members, receive external exposures in the initial period after therapy, arising from the (90)Y in the patient. The local skin doses of the individual staff members, measured during RITs and PRRTs with thermoluminescence detectors fixed with tapes to the fingers, vary considerably. The exposure of staff can exceed the annual permissible dose limit of 500 mSv if radiation protection standards are low. Thus, adequate safety measures are needed. Measurements of the dose rate around patients, made using survey meters with sufficient response to beta particles, indicate that the exposure of caregivers and family members is considerably higher than previously assumed, and was dominated by primary beta radiation instead of bremsstrahlung. Nevertheless, under normal circumstances, the annual dose limits for the public (effective dose: 1 mSv, skin dose: 50 mSv) will be complied with.
用(90)Y标记的化合物进行的放射免疫疗法(RITs)和肽受体放射疗法(PRRTs)为核医学中的肿瘤治疗提供了广阔前景。然而,在制备和实施这些疗法时,需要操作高活度的(90)Y(>1GBq),技术人员和医生可能会受到高剂量照射,主要是手部皮肤。即使是非职业暴露人员,如护理人员和家庭成员,在治疗后的初期也会因患者体内的(90)Y而受到外照射。在用热释光探测器通过胶带固定在手指上进行RITs和PRRTs期间测量的个别工作人员的局部皮肤剂量差异很大。如果辐射防护标准较低,工作人员的照射剂量可能会超过每年500mSv的允许剂量限值。因此,需要采取适当的安全措施。使用对β粒子有足够响应的巡测仪对患者周围剂量率进行测量表明,护理人员和家庭成员受到的照射比以前设想的要高得多,并且主要是由初级β辐射而不是轫致辐射造成的。尽管如此,在正常情况下,公众的年度剂量限值(有效剂量:1mSv,皮肤剂量:50mSv)将得到遵守。