Radiation Exposure and Safety Precautions Following 131Cs Brachytherapy in Patients with Brain Tumors.

TitleRadiation Exposure and Safety Precautions Following 131Cs Brachytherapy in Patients with Brain Tumors.
Publication TypeJournal Article
Year of Publication2017
AuthorsYondorf MZ, Schwartz TH, Boockvar JA, Pannullo S, Stieg P, Sabbas A, Pavese A, Trichter S, Nedialkova L, Parashar B, Nori D, Chao KSClifford, A Wernicke G
JournalHealth Phys
Volume112
Issue4
Pagination403-408
Date Published2017 04
ISSN1538-5159
KeywordsAged, Aged, 80 and over, Brachytherapy, Brain Neoplasms, Cesium Radioisotopes, Female, Humans, Male, Middle Aged, Occupational Exposure, Radiation Exposure, Radiation Injuries, Radiation Protection, Radiopharmaceuticals, Retrospective Studies, Safety Management
Abstract

Cesium-131 (Cs) brachytherapy is a safe and convenient treatment option for patients with resected brain tumors. This study prospectively analyzes radiation exposure in the patient population who were treated with a maximally safe neurosurgical resection and Cs brachytherapy. Following implantation, radiation dose rate measurements were taken at the surface, 35 cm, and 100 cm distances. Using the half-life of Cs (9.69 d), the dose rates were extrapolated at these distances over a period of time (t = 30 d). Data from dosimetry badges and rings worn by surgeons and radiation oncologists were collected and analyzed. Postoperatively, median dose rate was 0.2475 mSv h, 0.01 mSv h, and 0.001 mSv h and at 30 d post-implant, 0.0298 mSv h, 0.0012 mSv h, and 0.0001 mSv h at the surface, 35 cm, and 100 cm, respectively. All but one badge and ring measured a dose equivalent corresponding to ~0 mSv h, while 1 badge measured 0.02/0.02/0.02 mSv h. There was a significant correlation between the number of seeds implanted and dose rate at the surface (p = 0.0169). When stratified by the number of seeds: 4-15 seeds (n = 14) and 20-50 seeds (n = 4) had median dose rates of 0.1475 mSv h and 0.5565 mSv h, respectively (p = 0.0015). Using National Council on Radiation Protection guidelines, this study shows that dose equivalent from permanent Cs brachytherapy for the treatment of brain tumors is limited, and it maintains safe levels of exposure to family and medical personnel. Such information is critical knowledge for the neurosurgeons, radiation oncologists, nurses, hospital staff, and family as this method is gaining nationwide popularity.

DOI10.1097/HP.0000000000000551
Alternate JournalHealth Phys
PubMed ID28234701
Grant ListKL2 RR024997 / RR / NCRR NIH HHS / United States