How to do radiation protection and isolation after treatment with iodine 131 in patients with thyroid cancer

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Department of nuclear medicine, the First Affiliated Hospital of Zhongshan University, Rao Guohui:According to the domestic and foreign rele

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Department of nuclear medicine, the First Affiliated Hospital of Zhongshan University, Rao Guohui:

According to the domestic and foreign relevant guidelines for diagnosis and management of thyroid diseases, differentiated thyroid carcinoma (papillary carcinoma and follicular carcinoma) underwent total thyroidectomy or subtotal resection patients after routine with iodine -131 treatment and subsequent taking euthyrox treatment, namely "131 + operation + iodine euthyrox" model has been widely used in the medical profession. The utility model has the advantages that the existing and potential tumor cells can be eliminated, and the patients can survive for a long time, as well as facilitate the follow-up and the reexamination of the disease.

131 iodine treatment of thyroid cancer in strict accordance with the requirements of hospital isolation, 3 days can be discharged. The patient in a special ward, there is a dedicated toilet, the patient's clothing, bedding will be placed in the treatment of decay and separate washing. These can reduce the impact of irradiation. Patients with 131 iodine retention in the body is equal to or less than 1.11GBq (30mCi) can be discharged, usually in the next 3 days can be discharged, but still can not go to crowded public places, in particular, do not close contact with pregnant women and children. That is, as far as possible to do a good job of radiation protection, reduce unnecessary exposure!

Only a small number of hospitals in China, the establishment of nuclear medicine disciplines inpatient wards, generally require patients to go home observation, treatment.

A radioactive isotope of -131 that has a physical half-life of 8.04 days and is reduced by half after a period of 8 days. Coupled with the body's biological excretion, 8 days later, the body's radioactivity is very, very low. We found that after the clinical examination test: iodine 131, SPECT body scan as long as the patient without metastasis and lesions, more than 5 days after the body of the radioactivity of more than 95% have been ruled out, residues of only about 1 to about 5%. 131 iodine treatment, the general requirements of patients isolated time is 2 weeks, after 2 weeks is safe, no effect on others.

Suggested that the patient after 3 days of iodine intake, drinking water and repeated urination, in order to exclude the body of iodine in the body of 131 to reduce the exposure of the gonads, and more water to flush the toilet. Studies have shown that iodine 131 does not affect the birth or neonatal congenital evidence, but the patient needs to be born, pregnant, should take iodine after a year of 131.

Radiological protection measures: time protection, distance protection. For patients, mainly time and distance. Extend contact distance with others, and shorten contact time. Especially for pregnant women and infants need attention.

The safety problem of iodine 131 treatment of radiation, according to the U.S. Nuclear Regulatory Commission (NRC) regulations, in accordance with the following three standards, can release: radioactivity 1 residues do not exceed 33 mCi; 2 the distance of 1 meters below the radiation dose rate 7mR/h (0.07mSv/h); the 3 radiation dose for adults is not more than 5 mSv.

The American Journal of Medicine reported a patient's oral dose of -131 of iodine mCi between 70-150 and the patient returned home after taking the drug. Measurements revealed that the maximum radiation dose (0.58 mSv on average), the radiation dose to the family members between 0.001-1.09 mSv. The radiation dose is much lower than the prescribed dose limit (5 mSv) prescribed by the current NRC code. So, you do not have to worry about, and the family separated by 3-5 meters, a very small amount of radiation to the family, the family is in the safe range

 

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