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英国甲状腺癌放射性碘治疗成年患者的患者准备及辐射防护指南

Patient Preparation and Radiation Protection Guidance for Adult Patients Undergoing Radioiodine Treatment for Thyroid Cancer in the UK.

作者信息

Wadsley J, Armstrong N, Bassett-Smith V, Beasley M, Chandler R, Cluny L, Craig A J, Farnell K, Garcez K, Garnham N, Graham K, Hallam A, Hill S, Hobrough H, McKiddie F, Strachan M W J

机构信息

Weston Park Cancer Centre, Sheffield, UK.

Northern Centre for Cancer Care, Newcastle, UK.

出版信息

Clin Oncol (R Coll Radiol). 2023 Jan;35(1):42-56. doi: 10.1016/j.clon.2022.07.002. Epub 2022 Aug 24.

Abstract

Radioactive iodine is a highly effective treatment for thyroid cancer and has now been used in clinical practice for more than 80 years. In general, the treatment is well tolerated. However, it can be logistically quite complex for patients due to the need to reduce iodine intake and achieve high levels of thyroid-stimulating hormone prior to treatment. Radiation protection precautions must also be taken to protect others from unnecessary radiation exposure following treatment. It has been well documented by thyroid cancer patient support groups that there is significant variation in practice across the UK. It is clear that some patients are being asked to observe unnecessarily burdensome restrictions that make it more difficult for them to tolerate the treatment. At the instigation of these support groups, a multidisciplinary group was assembled to examine the evidence and generate guidance on best practice for the preparation of patients for this treatment and the management of subsequent radiation protection precautions, with a focus on personalising the advice given to individual patients. The guidance includes advice about managing particularly challenging situations, for example treating patients who require haemodialysis. We have also worked together to produce a patient information leaflet covering these issues. We hope that the guidance document and patient information leaflet will assist centres in improving our patients' experience of receiving radioactive iodine. The patient information sheet is available as Supplementary Material to this article.

摘要

放射性碘是治疗甲状腺癌的一种高效疗法,现已在临床实践中使用了80多年。一般来说,这种治疗的耐受性良好。然而,由于在治疗前需要减少碘摄入量并使促甲状腺激素达到高水平,这对患者来说在安排上可能相当复杂。治疗后还必须采取辐射防护措施,以保护他人免受不必要的辐射暴露。甲状腺癌患者支持组织已有充分记录表明,英国各地的实际做法存在显著差异。很明显,一些患者被要求遵守不必要的繁重限制,这使他们更难耐受治疗。在这些支持组织的鼓动下,成立了一个多学科小组来审查证据,并就患者接受该治疗的准备工作以及后续辐射防护措施的管理制定最佳实践指南,重点是为个体患者提供个性化建议。该指南包括有关处理特别具有挑战性情况的建议,例如治疗需要血液透析的患者。我们还共同编写了一份涵盖这些问题的患者信息手册。我们希望该指南文件和患者信息手册将有助于各中心改善我们患者接受放射性碘治疗的体验。患者信息表作为本文的补充材料提供。

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