An investigation of hospitalization management and radiation protection in 131I treatment for thyroid cancer / 中国辐射卫生

ABSTRACT

Objective To investigate the status and problems of hospitalization management and radiation protection in 131I treatment for thyroid cancer, and to provide suggestions for medical institutions to implement relevant standards. Methods We investigated the status of radiation protection and management in 10 medical institutions conducting 131I treatment for thyroid cancer (6 in Shanghai, 2 in Zhejiang Province, and 2 in Jiangsu Province, China) by consulting written materials, expert interviews, and on-site inspection and testing. Results The average activity of 131I therapy for thyroid cancer in the 10 medical institutions was 110~120 mCi (4.07~4.44 GBq). All patients who received the treatment were hospitalized, with a stay of 3~7 days. Seven institutions carried out 131I dispensing, 6 of which used automatic 131I dispensing instruments. Nine institutions had an independent ventilation system in the wards, 8 of which regularly changed the filters. All the 10 institutions set special toilets and shower rooms in the wards, and had shielding facilities between sickbeds, with the lead equivalent from 0.5 mm Pb (lowest) to 10 mm Pb (highest). All the 10 institutions had intercom and monitoring facilities in the wards, 9 of which had a one-way access control system, and 4 of which had dose monitoring equipment. Nine institutions carried out surface pollution monitoring in the workplace, but none performed air pollution testing. All the 10 institutions required the radioactivity in the body of patients be less than 400 MBq before discharge, and five of them estimated the activity by measuring the dose rate at a certain distance from the body surface of patients. All the 10 institutions had radioactive sewage decay ponds, but none of them conducted regular monitoring. Rapid on-site surface pollution testing in the wards showed that highest value was 31.9 Bq/cm2. Conclusion The 10 medical institutions carried out 131I treatment for thyroid cancer basically according to the requirements of national laws, regulations, and standards, but there are still some problems in ward construction, radiation protection facilities, and patient hospitalization management, which should be further standardized.