Department for Radiation Protection and Medical Physics, Hannover Medical School, Hannover, Germany.
Bayer AG, Berlin, Germany.
Z Med Phys. 2021 Feb;31(1):58-64. doi: 10.1016/j.zemedi.2020.09.002. Epub 2020 Dec 10.
A multicenter study was conducted to assess the radiation exposure of relatives and caregivers of patients suffering from castration resistant prostate cancer with bone metastases and treated with Ra-223 dichloride in an outpatient setting. As Ra-223 and most of its progeny emit alpha particles, especially the internal exposure of persons in the patient's vicinity had to be evaluated.
The external radiation was measured in distances of 1 m and 2 m. Wipe-tests were taken in the patients' homes to identify significant contaminations and evaluated by liquid scintillation counting. Samples of saliva and sweat were taken and measured using gamma spectrometry.
The external exposure from the patients measured 10-20min post injection (p. i.) was<0.080μSv/h in median in 1 m distance (range: below decision threshold (<DT) - 0.208μSv/h). Ra-223 was found in saliva (median 20-30 min p. i.: 27 Bq/g, range: 12.6 - 110 Bq/g) and excreted with sweat (median: 0.121 Bq/cm, range: 0.020 - 0.524 Bq/cm) in the first 24h p. i. Contaminations in restrooms and kitchens were low (median: 0.026 - 0.215 mBq/cm, depending on location; range:<DT - 2.1 mBq/cm).
The potential exposure of relatives by external irradiation and incorporation of Ra-223 excreted by the patient with saliva or sweat is estimated to be well below 1 mSv. No objections are seen regarding outpatient treatment.
一项多中心研究评估了在门诊环境下，用镭-223 二氯化物治疗患有去势抵抗性前列腺癌骨转移的患者，其亲属和护理人员的辐射暴露情况。由于镭-223 及其大部分产物会发射阿尔法粒子，因此必须评估患者附近人员的内照射。
在 1 米和 2 米的距离测量外部辐射。在患者家中进行擦拭测试，以确定显著污染，并通过液体闪烁计数进行评估。采集唾液和汗液样本，并使用伽马谱仪进行测量。
注射后 10-20 分钟（p.i.），患者的外照射在 1 米距离处中位数<0.080μSv/h（范围：低于决策阈值（
亲属通过外部照射和患者随唾液或汗液排出的镭-223 摄入的潜在暴露估计远低于 1 mSv。门诊治疗没有问题。
