Department of Radiology, School of Medicine, University of São Paulo, São Paulo, Brazil.
Clin Nucl Med. 2011 Jun;36(6):440-5. doi: 10.1097/RLU.0b013e3182184fa0.
To evaluate the dosimetric effect of outpatient radioiodine therapy for thyroid cancer in members of a patient's family and their living environment, when using iodine-131 doses reaching 7.4 GBq. The following parameters were thus defined: (a) whole-body radiation doses to caregivers, (b) the production of contaminated solid waste, and (c) radiation potential and surface contamination within patients' living quarters.
In total, 100 patients were treated on an outpatient basis, taking into consideration their acceptable living conditions, interests, and willingness to comply with medical and radiation safety guidelines. Both the caregivers and the radiation dose potentiality inside patients' residences were monitored by using thermoluminescent dosimeters. Surface contamination and contaminated solid wastes were identified and measured with a Geiger-Müller detector.
A total of 90 monitored individuals received a mean dose of 0.27 (±0.28) mSv, and the maximum dose registered was 1.6 mSv. The mean value for the potential dose within all living quarters was 0.31 (±0.34) mSv, and the mean value per monitored surface was 5.58 Bq/cm(2) for all the 1659 points measured. The overall production of contaminated solid wastes was at a low level, being about 3 times less than the exemption level indicated by the International Atomic Energy Agency.
This study indicates that the treatment of thyroid cancer by applying radioiodine activities up to 7.4 GBq, on an outpatient basis, is a safe procedure, especially when supervised by qualified professionals. This alternative therapy should be a topic for careful discussion considering the high potential for reducing costs in healthcare and improving patient acceptance.
评估使用达到 7.4GBq 的碘-131 剂量为甲状腺癌患者家庭成员及其生活环境进行门诊放射性碘治疗的剂量学效应。因此定义了以下参数：（a）照顾者的全身辐射剂量，（b）污染固体废物的产生，以及（c）患者居住区内的辐射潜力和表面污染。
总共为 100 名患者进行了门诊治疗，考虑到他们可接受的生活条件、兴趣以及遵守医疗和辐射安全指南的意愿。通过使用热释光剂量计监测照顾者和患者住所内的辐射剂量潜力。使用盖革-弥勒探测器识别和测量表面污染和污染固体废物。
共监测 90 人，平均剂量为 0.27（±0.28）mSv，记录的最大剂量为 1.6mSv。所有居住区内潜在剂量的平均值为 0.31（±0.34）mSv，测量的 1659 个点中每个监测表面的平均值为 5.58Bq/cm²。污染固体废物的总体产生量处于较低水平，约为国际原子能机构规定的豁免水平的 3 倍。
本研究表明，应用高达 7.4GBq 的放射性碘活度进行甲状腺癌的门诊治疗是一种安全的治疗方法，特别是在合格专业人员的监督下。这种替代治疗方法应作为一个话题进行仔细讨论，因为它有可能降低医疗保健成本并提高患者的接受程度。
