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      Radiation protection assessment for 177Lu-Dotatate therapy

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          Abstract

          Objective To comprehensively evaluate the radiation protection of 177Lu-Dotatate therapy, and to provide a reference for standardizing and restraining patient behavior and activities after discharge and establishing relevant standards.

          Methods The radiation protection of 177Lu-Dotatate therapy started with the infusion of radiopharmaceuticals. The time points of each event in daily activities during and after therapy were listed in a chronological order, as well asthe persons with possible radiation exposure and their contact distance and contact duration in each event. The in vivo pharmacokinetic data in the instructions of 177Lu-Dotatate were used to estimate 177Lu activity in the patient’s body at each time point, and the formula for radiation dose in GBZ 120—2020 was used to estimate the radiation dose of the patient on the persons around him/her.

          Results 177Lu-Dotatate was administered to the patient at a dose of 7400 MBq when the patient attended the outpatient service or was hospitalized for treatment. The cumulative radiation dose was calculated for the medical staff, the public, colleagues, caregivers, adult family members, and the family members of children aged 3~10 years, and the measures for standardizing and restraining the patient’s behaviors were given when the dose constraint value for related persons in national standard was met. The conditions for realizing the requirement in national standard that pregnant women and family members aged < 3 years should avoid contact was also proposed in this article.

          Conclusion From the perspective of radiation protection, under the premise of standardizing and restraining the behavior of patients treated with 177Lu-Dotatate after discharge, both ambulatory treatment and hospitalization are safe and feasible; if the activities of patients are no restrained after discharge, the radiation dose for family members, the public, and colleagues might exceed the dose limits or constraint values in relevant national standards.

          Abstract

          摘要: 目的177Lu-Dotatate 治疗的放射防护进行全面评估, 为规范约束患者出院后的行为活动及建立相关标准提 供参考依据。 方法 177Lu-Dotatate 治疗的放射防护从输注药物开始, 按时间顺序列出患者在治疗及其后的日常活动中 的各事件时间节点, 对应列出事件中可能的受照人员、接触距离和接触时长;用 177Lu-Dotatate 说明书中的体内动力学 数据估算各时间点患者体内 177Lu 活度;使用 GBZ 120—2020 中的照射剂量公式估算患者对周围人员的照射剂量。 结果 对患者 177Lu-Dotatate 门诊或住院治疗每次用药 7 400 MBq, 并重复4次的情况估算累积照射剂量:给出了医护 人员、公众、同事、陪护人、成人家属、3~10 岁儿童家属的累积照射剂量, 并给出了满足国标中相关人员剂量约束值时 应采取的规范约束行为。对国标要求孕妇及 3 岁以下家属应避免接触的情况, 提出了实现此要求的条件。 结论 从放 射防护角度, 在对 177Lu-Dotatate 治疗患者出院后的行为加以规范约束的前提下, 无论门诊还是住院治疗都是安全可行 的;若不限制约束患者出院后的活动, 则对家属、公众及同事造成的照射剂量都可能会超过国家相关标准的剂量限值 或约束值。

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          Author and article information

          Journal
          CJRH
          Chinese Journal of Radiological Health
          Chinese Preventive Medical Association (Ji’an, China )
          1004-714X
          01 December 2021
          01 January 2022
          : 30
          : 6
          : 710-719
          Affiliations
          [1] 1Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021 China
          [2] 2Department of Nuclear Medicine, First Medical Center of Chinese PLA General Hospital, Beijing 100853 China
          [3] 3Nuclear and Radiation Safety Center, Beijing 102442 China
          Author notes
          Corresponding author: CHEN Yingmao, E-mail: chen.ym@ 123456263.net
          Article
          j.issn.1004-714X.2021.06.011
          10.13491/j.issn.1004-714X.2021.06.011
          b86614e1-e4c8-4660-8a92-08316fb06a51
          © 2021 Chinese Journal of Radiological Health

          This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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          Categories
          Journal Article

          Medicine,Image processing,Radiology & Imaging,Bioinformatics & Computational biology,Health & Social care,Public health
          Dose Estimation,Therapy, 177Lu-dotatate,Radiation Protection

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