McMaster University Health Physics Department, Hamilton, ON, Canada.
Fox Chase Cancer Center, Philadelphia, PA.
Health Phys. 2023 Feb 1;124(2):139-146. doi: 10.1097/HP.0000000000001644. Epub 2022 Dec 10.
177 Lu therapy as part of theranostic treatment for cancer is expanding but it can be a challenge for sites with limited radiation protection staff to implement the radiation safety program required for therapeutic nuclear medicine.
To increase the adoption of 177 Lu therapy, especially in smaller centers and clinics, by providing a collection of radiation safety best practices and operational experience. To provide a resource for radiation safety officers supporting the implementation of a 177 Lu therapy program.
A panel of 11 radiation safety professionals representing sites across Canada and the United States with experience delivering 177 Lu therapy was assembled and discussed their responses to a list of questions focused on the following radiation safety topics: facility layout and design; radiation safety program; and drug management and patient care.
A comprehensive set of best practice guidelines for clinical radiation safety during 177 Lu therapy has been developed based on the collective operational experience of a group of radiation safety professionals. Significant findings included that 177 Lu therapy is often safely administered in unshielded rooms, that staff radiation exposure associated with 177 Lu therapy is minimal relative to other nuclear medicine programs, and that some relatively simple preparation in advance including papering of common surfaces and planning for incontinence can effectively control contamination during therapy.
The guidance contained in this paper will assist radiation safety professionals in the implementation of safe, effective 177 Lu therapy programs, even at smaller sites with limited to no experience in therapeutic nuclear medicine.
作为癌症治疗的诊断与治疗的一部分，177Lu 治疗正在不断发展，但对于辐射防护人员有限的站点来说，实施治疗核医学所需的辐射安全计划可能是一个挑战。
通过提供一系列辐射安全最佳实践和运营经验，增加 177Lu 治疗的采用，特别是在较小的中心和诊所。为支持 177Lu 治疗计划实施的辐射安全官员提供资源。
组建了一个由 11 名代表加拿大和美国各地具有 177Lu 治疗经验的站点的辐射安全专业人员组成的小组，并讨论了他们对一系列问题的回答，这些问题集中在以下辐射安全主题上：设施布局和设计；辐射安全计划；以及药物管理和患者护理。
根据一组辐射安全专业人员的集体运营经验，制定了一套全面的 177Lu 治疗期间临床辐射安全最佳实践指南。主要发现包括：177Lu 治疗通常可以在无屏蔽的房间内安全进行；与其他核医学计划相比，与 177Lu 治疗相关的工作人员辐射暴露量很小；一些相对简单的提前准备，包括常见表面的裱糊和失禁计划，可以有效地控制治疗期间的污染。
本文中的指南将帮助辐射安全专业人员实施安全有效的 177Lu 治疗计划，即使是在治疗核医学经验有限或没有经验的较小站点也是如此。
