Radiation protection in 177Lu-DOTATOC therapies: Isolation time, dose estimates to representative persons, and patient recommendations
DOI:
https://doi.org/10.35509/01239015.842Keywords:
177Lu-DOTATOC, caregivers, radiation exposure, radiation protectionAbstract
Background: 177Lu-DOTA-peptide has shown efficacy in the treatment of neuroendocrine tumors, leading to an increase in the number of therapies at the Instituto Nacional de Cancerología (INC), Bogotá, Colombia. National and international regulations do not currently have protocols associated with the discharge of patients treated with 177Lu.
Objective: This study aims to establish discharge recommendations for patients treated with 177Lu-DOTATOC that guarantee safety conditions and radiation protection for caregivers and family members based on the evaluation of effective doses to this representative group.
Materials and methods: Retrospective analysis of 177Lu-DOTATOC therapy administered to 9 patients with neuroendocrine tumors treated at the INC. Internal dosimetry was performed, and the dose rate was estimated for times after administration. Situations were modeled in representative people (patients and public) for effective dose estimation. Calculation includes doses after eight days and four cycles after treatment.
Results: Fast and slow effective half-life times were found to be 4.96 ± 0.94 h and 61.02 ± 4.14 h, respectively, with estimated dose rate at 1 m from the patient at 6 h of 25.5 μSv/h and 9.0 μSv/h at 24 h d. In representative individuals, a higher effective dose is found at sleeping with a partner for eight hours at 0.3 meters. The results are 10 % below the annual public limit and about 80 % below the limit for caregivers.
Conclusion: Except for clinical conditions, 177Lu-DOTATOC therapy can be safely performed as outpatient treatment, with at least 6 hours of isolation after administration, or with a dose rate lower than 25.5 μSv/h, without affecting the existing radiation safety conditions for companions or caregivers, occupationally exposed personnel, and the public when the radiation protection recommendations suggested in this study are maintained.
Author Biographies
Nathaly Barbosa, Grupo Medicina Nuclear, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
1. Grupo Medicina Nuclear, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Franklin Niño, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
2. Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
Lorena Sandoval, Grupo Medicina Nuclear, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
1. Grupo Medicina Nuclear, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Erika Cely, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
2. Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
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