DOCSLIB.ORG

Abnormal Occurrence Print

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Abnormal Occurrence Print Event Detail - Abnormal Occurrence Print ITEMNO 950291 AO_NO: NRC 95-04 DATE: 03/14/1995 TITLE: MEDICAL BRACHYTHERAPY MISADMINISTRATION AT THE UNIVERSITY OF VIRGINIA, IN CHARLOT NAME: University of Virginia Medical Cent CITY: Charlottesville STATE: VA Nature and Probable Consequences: NRC Action: A patient was prescribed a manual brachytherapy NRC conducted a special inspection on March 23-24, procedure using cesium-137 (Cs-137) sources loaded in 1995, to review the circumstances surrounding the an applicator, for a total gynecological treatment dose of misadministration. The inspection report was issued on 3000 centigray (cGy) (3000 rad). May 2, 1995. Enforcement action will be taken as appropriate. Cause: Other Agency Action: The licensee's staff involved in the brachytherapy procedure were not familiar with handling of the applicator that contained the Cs-137 sources. Also, because of anatomic characteristics of the patient, the physician had difficulty inserting the source carrier into the applicator. Licensee Action: Criteria: The licensee provided training for its staff, involved in The following information pertaining to this event is also brachytherapy procedures, concerning the precautions being reported in the Federal Register. Appendix A (see which must be taken when handling an applicator such as Event Type 3 in Table A-1) of this report notes that a the one used in the subject procedure. Also, emphasis therapeutic exposure to any part of the body not was placed on the need to be more attentive during the scheduled to receive radiation can be considered an AO. source insertion process in order to account for all ITEMNO 950645 AO_NO: NRC 95-05 DATE: 05/09/1995 TITLE: MEDICAL THERAPEUTIC RADIOPHARMACEUTICAL MISADMINISTRATION OF IODINE-131 AT MASS NAME: Massachusetts General Hospital CITY: Boston STATE: MA Nature and Probable Consequences: NRC Action: A patient was prescribed a 296 megabecquerel (MBq) (8 NRC performed an inspection on May 12, 1995, to learn millicurie [mCi]) dosage of iodine-131 (I-131) for about the event and determined that it constituted a hyperthyroidism; however, a dosage of 1106.3 MBq (29.9 misadministration as defined in 10 CFR 35.2. NRC mCi) was administered. determined that this was an isolated violation of the licensee's Quality Management Program and issued a Cause: Other Agency Action: The licensee stated that this event occurred because of a human error. The technologist involved in this procedure inadvertently switched the labeled lids on the vial shields containing the I-131 dosages prescribed for different patients. Additionally, the technician failed to check for Licensee Action: Criteria: The licensee instituted a procedure for checking the vial The following information pertaining to this event is also label before giving a dose. In addition, the licensee is being reported concurrently in the Federal Register. obtaining a second dose calibrator which will be used in Appendix A (see Event Type 5 [a] in Table A-1) of this the out-patient dosing room of the Thyroid Clinic. Each report notes that administering a therapeutic dose of a dose will be re-assayed immediately before the I-131 is radiopharmaceutical differing from the prescribed dose by administered to the patient rather than relying on the more than 10 percent and the actual dose is greater than ITEMNO 950755 AO_NO: NRC 95-06 DATE: 05/09/1995 TITLE: MULTIPLE MEDICAL BRACHYTHERAPY MISADMINISTRATIONS AT MADIGAN ARMY MEDICAL CEN NAME: Madigan Army Medical Center CITY: Fort Lewis STATE: WA Nature and Probable Consequences: NRC Action: Four patients were prescribed brachytherapy procedures, NRC initiated an inspection on June 6, 1995, to review using iridium-192 seeds of different source strengths, and the circumstances associated with the misadministrations received doses other than those prescribed because of and to review the licensee's corrective actions. (As of the the same computer input error. (The same computer input date of this report, the inspection is ongoing.) An NRC error could cause either underdoses or overdoses medical consultant will review each case in order to Cause: Other Agency Action: Based upon NRC's initial review of the misadministrations, it appears that the probable causes of the treatment errors were failures to: (1) independently review or check the data input to the computerized treatment planning system, and (2) perform an Licensee Action: Criteria: The physics staff at MAMC promptly corrected the data The following information pertaining to this event is also entered into the computer treatment planning computer, being reported concurrently in the Federal Register. recalculated the doses received by the patients, and took Appendix A (see Event Type 5[d] in Table A-1) of this steps to ensure that appropriate data will be used for report notes that administering a therapeutic dose from a future treatment plans. sealed source such that the treatment dose differs from the prescribed dose by more than 10 percent and the ITEMNO 950290 AO_NO: AS 95-02 DATE: 03/14/1995 TITLE: MEDICAL BRACHYTHERAPY MISADMINISTRATION BY MOBILE TECHNOLOGY, INC., AT IRVINE ME NAME: Irvine Medical Center CITY: Irvine STATE: CA Nature and Probable Consequences: NRC Action: A patient was prescribed a brachytherapy treatment to the left lung using a high dose rate (HDR) remote afterloading unit. However, because of an error the patient received 800 centigray (800 rad) to the right lung. Cause: Other Agency Action: A chest x-ray showing that the HDR remote afterloading The State Agency requested that the licensee take the unit's positioning catheter was erroneously placed in the above corrective actions. right lung was not reviewed by either the pulmonologist or the radiation oncologist. This event is considered closed for the purpose of this report. Licensee Action: Criteria: The licensee took the following actions to prevent Appendix A (see Event Type 3 in Table A-1) of this report recurrence: (1) real-time fluoroscopy will be used at the notes that a therapeutic exposure to any part of the body time of the bronchoscopy; (2) a guide wire will be utilized not scheduled to receive radiation can be considered an within all bronchial catheters at the time of the AO. bronchoscopy; (3) a chest x-ray will be obtained and reviewed by the participating physicians immediately ITEMNO 950451 AO_NO: AS 95-03 DATE: 04/06/1995 TITLE: OVEREXPOSURE OF PERSONNEL AT GWINNETT MEDICAL CENTER IN LAWRENCEVILLE, GEORGI NAME: Gwinnett Medical Center CITY: Lawrenceville STATE: GA Nature and Probable Consequences: NRC Action: Licensee personnel involved in a brachytherapy treatment using iridium-192 seeds received exposures above minimum as a result of handling what they assumed was a dummy source. The personnel included physicists, physicians, technologists and nursing staff. One of the Cause: Other Agency Action: The licensee stated that the overexposures occurred The Department of Natural Resources of the State of because: (1) the hospital procedures were not followed Georgia investigated the incident. The corrective and when ordering the radioactive material; (2) the personnel preventative actions submitted by the licensee will be handling the iridium-192 seeds assumed that they were reviewed during the next inspection by the Department. dummy sources; (3) the physicist who primarily handled Enforcement action will be taken as appropriate. Licensee Action: Criteria: The licensee addressed the issues involving the incident, Appendix A (see For All Licensees, Criterion No. 1) of this and either has or will implement corrective actions to report notes that exposure of the feet, ankles, hands or prevent recurrence. Exposure dose calculations have forearms of any individual to 375 rem or more of radiation been made by a certified health physicist. The personnel can be considered an AO. training and accreditation program has been modified. Physicist A and Physicist B have received inservice ITEMNO 950065 AO_NO: AS 95-04 DATE: 07/28/1994 TITLE: MEDICAL BRACHYTHERAPY MISADMINISTRATION AT SOUTHWEST TEXAS METHODIST HOSPITA NAME: Southwest Texas Methodist Hospit CITY: San Antonio STATE: TX Nature and Probable Consequences: NRC Action: Two patients were prescribed brachytherapy procedures using manual loading for prostate treatment. One prescribed to receive a dose of 160 gray (Gy) (16,000 rad) of iodine-125 and the other was prescribed a dose of 115 Gy (11,500 rad) of palladium-103. However, Cause: Other Agency Action: The licensee was unable to determine how the The State Agency investigated the incident and reviewed misidentification occurred. the new procedures of prostate implants. No violations were cited. This event is considered closed for the purpose of this Licensee Action: Criteria: The Radiation Safety Committee immediately Appendix A (see Event Type 5[d] in Table A-1) of this implemented new procedures for ordering, receiving, report notes that administering a therapeutic dose from a loading, sterilizing, and implanting prostate implants. sealed source such that the treatment dose differs from the prescribed dose by more than 10 percent and the event (regardless of health effects) affects two or more patients at the same facility can be considered an AO ITEMNO 960191 AO_NO: AS 95-01 DATE: 05/23/1993 TITLE: MEDICAL TELETHERAPY MISADMINISTRATION AT AN "UNSPECIFIED LICENSEE" IN NEW YORK, N NAME: Unspecified Licensee CITY: New York STATE: NY Nature and Probable Consequences: NRC Action: A patient was prescribed a total dose to the right superclavicular area and spine of 2400 centigray (cGy) (2400 rad) using cobalt-60 teletherapy equipment. During simulation, the technologist erroneously placed the preparatory tattoo marking the treatment area on the Cause: Other Agency Action: The misadministration occurred because the licensee Acting under authority granted by the State Agency, the staff marked the wrong treatment area on the patient New York City Bureau of Radiological Health investigated during a simulation in preparation for treatment. the misadministration and submitted its investigative reports to NRC. The reports contained information about the licensee's actions to prevent recurrence.
Load more

Recommended publications
  • Table 2.Iii.1. Fissionable Isotopes1
    FISSIONABLE ISOTOPES Charles P. Blair Last revised: 2012 “While several isotopes are theoretically fissionable, RANNSAD defines fissionable isotopes as either uranium-233 or 235; plutonium 238, 239, 240, 241, or 242, or Americium-241. See, Ackerman, Asal, Bale, Blair and Rethemeyer, Anatomizing Radiological and Nuclear Non-State Adversaries: Identifying the Adversary, p. 99-101, footnote #10, TABLE 2.III.1. FISSIONABLE ISOTOPES1 Isotope Availability Possible Fission Bare Critical Weapon-types mass2 Uranium-233 MEDIUM: DOE reportedly stores Gun-type or implosion-type 15 kg more than one metric ton of U- 233.3 Uranium-235 HIGH: As of 2007, 1700 metric Gun-type or implosion-type 50 kg tons of HEU existed globally, in both civilian and military stocks.4 Plutonium- HIGH: A separated global stock of Implosion 10 kg 238 plutonium, both civilian and military, of over 500 tons.5 Implosion 10 kg Plutonium- Produced in military and civilian 239 reactor fuels. Typically, reactor Plutonium- grade plutonium (RGP) consists Implosion 40 kg 240 of roughly 60 percent plutonium- Plutonium- 239, 25 percent plutonium-240, Implosion 10-13 kg nine percent plutonium-241, five 241 percent plutonium-242 and one Plutonium- percent plutonium-2386 (these Implosion 89 -100 kg 242 percentages are influenced by how long the fuel is irradiated in the reactor).7 1 This table is drawn, in part, from Charles P. Blair, “Jihadists and Nuclear Weapons,” in Gary A. Ackerman and Jeremy Tamsett, ed., Jihadists and Weapons of Mass Destruction: A Growing Threat (New York: Taylor and Francis, 2009), pp. 196-197. See also, David Albright N 2 “Bare critical mass” refers to the absence of an initiator or a reflector.
    [Show full text]
  • Institute for Clinical and Economic Review
    INSTITUTE FOR CLINICAL AND ECONOMIC REVIEW FINAL APPRAISAL DOCUMENT BRACHYTHERAPY & PROTON BEAM THERAPY FOR TREATMENT OF CLINICALLY-LOCALIZED, LOW-RISK PROSTATE CANCER December 22, 2008 Senior Staff Daniel A. Ollendorf, MPH, ARM Chief Review Officer Julia Hayes, MD Lead Decision Scientist Pamela McMahon, PhD Sr. Decision Scientist Steven D. Pearson, MD, MSc President, ICER Associate Staff Michelle Kuba, MPH Sr. Technology Analyst Angela Tramontano, MPH Research Assistant © ICER, 2008 1 CONTENTS About ICER .................................................................................................................................. 3 Acknowledgments ...................................................................................................................... 4 Executive Summary .................................................................................................................... 5 Evidence Review Group Deliberation.................................................................................. 15 ICER Integrated Evidence Rating.......................................................................................... 21 Evidence Review Group Members........................................................................................ 24 Appraisal Overview.................................................................................................................. 28 Background ...............................................................................................................................
    [Show full text]
  • Californiachoice® Small Group Advantage PPO Three-Tier Hospital Network
    CaliforniaChoice® Small Group Advantage PPO three-tier hospital network With the CaliforniaChoice Advantage PPO plans, you have a choice of tiers (or levels) of hospitals to visit. Tier one hospitals offer the greatest savings to you. Tier two hospitals have the second best level of savings. Tier three hospitals — or out-of-network hospitals — offer the least out-of-pocket savings, but you’ll still be covered. Keep in mind that the tier levels aren’t based on the quality of care given at each hospital. They’re based on which hospitals have shown they’re better able to give quality care that’s also cost effective. Our three-tier levels* are: }}Tier 1 — PPO network hospitals with lower-negotiated hospital reimbursement rates. }}Tier 2 — the remaining PPO network hospitals. }}Tier 3 — non-network hospitals. * The tier levels are not based on the quality of care given at each hospital. Instead, each level stands for the hospitals that show 19685CABENABC 08/15 the best use of health care dollars. CaliforniaChoice® Small Group Advantage PPO three-tier hospital network Here is a list of the Tier-1 and Tier-2 hospitals included in the network. Any hospital not listed is considered out of network. Hospital County Tier St Rose Hospital Alameda 1 Alameda Hospital Alameda 1 Children’s Hospital Oakland Alameda 2 Valleycare Medical Center Alameda 2 Washington Hospital Alameda 2 Sutter Amador Health Center Pioneer 1 Sutter Amador Health Center Plymouth 1 Sutter Amador Hospital Amador 1 Oroville Hospital & Medical Center Butte 1 Feather River Hospital
    [Show full text]
  • Access+ HMO 2021Network
    Access+ HMO 2021Network Our Access+ HMO plan provides both comprehensive coverage and access to a high-quality network of more than 10,000 primary care physicians (PCPs), 270 hospitals, and 34,000 specialists. You have zero or low copayments for most covered services, plus no deductible for hospitalization or preventive care and virtually no claims forms. Participating Physician Groups Hospitals Butte County Butte County BSC Admin Enloe Medical Center Cohasset Glenn County BSC Admin Enloe Medical Center Esplanade Enloe Rehabilitation Center Orchard Hospital Oroville Hospital Colusa County Butte County BSC Admin Colusa Medical Center El Dorado County Hill Physicians Sacramento CalPERS Mercy General Hospital Mercy Medical Group CalPERS Methodist Hospital of Sacramento Mercy Hospital of Folsom Mercy San Juan Medical Center Fresno County Central Valley Medical Medical Providers Inc. Adventist Medical Center Reedley Sante Community Physicians Inc. Sante Health Systems Clovis Community Hospital Fresno Community Hospital Fresno Heart and Surgical Hospital A Community RMCC Fresno Surgical Hospital San Joaquin Valley Rehabilitation Hospital Selma Community Hospital St. Agnes Medical Center Glenn County Butte County BSC Admin Glenn Medical Center Glenn County BSC Admin Humboldt County Humboldt Del Norte IPA Mad River Community Hospital Redwood Memorial Hospital St. Joseph Hospital - Eureka Imperial County Imperial County Physicians Medical Group El Centro Regional Medical Center Pioneers Memorial Hospital Kern County Bakersfield Family Medical
    [Show full text]
  • NUREG-1350, Vol. 31, Information
    NRC Figure 31. Moisture Density Guage Bioshield Gauge Surface Detectors Depth Radiation Source GLOSSARY 159 GLOSSARY Glossary (Abbreviations, Definitions, and Illustrations) Advanced reactors Reactors that differ from today’s reactors primarily by their use of inert gases, molten salt mixtures, or liquid metals to cool the reactor core. Advanced reactors can also consider fuel materials and designs that differ radically from today’s enriched-uranium dioxide pellets within zirconium cladding. Agreement State A U.S. State that has signed an agreement with the U.S. Nuclear Regulatory Commission (NRC) authorizing the State to regulate certain uses of radioactive materials within the State. Atomic energy The energy that is released through a nuclear reaction or radioactive decay process. One kind of nuclear reaction is fission, which occurs in a nuclear reactor and releases energy, usually in the form of heat and radiation. In a nuclear power plant, this heat is used to boil water to produce steam that can be used to drive large turbines. The turbines drive generators to produce electrical power. NUCLEUS FRAGMENT Nuclear Reaction NUCLEUS NEW NEUTRON NEUTRON Background radiation The natural radiation that is always present in the environment. It includes cosmic radiation that comes from the sun and stars, terrestrial radiation that comes from the Earth, and internal radiation that exists in all living things and enters organisms by ingestion or inhalation. The typical average individual exposure in the United States from natural background sources is about 310 millirem (3.1 millisievert) per year. 160 8 GLOSSARY 8 Boiling-water reactor (BWR) A nuclear reactor in which water is boiled using heat released from fission.
    [Show full text]
  • Security of Supply of Medical Radioisotopes - a Clinical View Dr Beverley Ellis Consultant Radiopharmacist
    Security of Supply of Medical Radioisotopes - a clinical view Dr Beverley Ellis Consultant Radiopharmacist Nuclear Medicine Centre Manchester University NHS Foundation Trust Nuclear Medicine § Approx 35 million clinical radionuclide imaging procedures worldwide § Globally 2nd most common imaging technique after CT (higher than MR) 20 million in USA 9 million in Europe 3 million in Japan 3 million in rest of the world Approx 700, 000 nuclear medicine procedures per year in UK Myocardial Perfusion - Ischaemia Stress Stress SA Rest Stress VLA Rest Stress HLA Rest Rest Tc-99m Bone Scans Normal Metastases Mo-99/Tc-99m Generator Supply Tc-99m Radiopharmaceutical Production Mo-99 Shortages Design of Clinical Services to Reduce Tc-99m Use § Optimisation of generator management – Efficiency savings – Delivery and extraction schedules – Patient scheduling § Improved communication – Customers – Suppliers § Improved software – gamma cameras – Produce comparable quality images using less radioactivity Global Situation § OECD/Nuclear Energy Agency (NEA) – Set up High Level Group (HLG-MR) in 2009 – Security of supply of Mo-99 and Tc-99m – Established 6 principles e.g. full cost recovery and outage reserve capacity – Issued a series of publications Global Situation § AIPES (Association of Imaging Producers & Equipment supplies) (Now called Nuclear Medicine Europe) – Support coordination of research reactor schedules Global Situation § Increased Mo-99 Production Capacity – Mo-99 suppliers – acquire additional capacity to cover shortfalls (Outage
    [Show full text]
  • Trends in Targeted Prostate Brachytherapy: from Multiparametric MRI to Nanomolecular Radiosensitizers
    Nicolae et al. Cancer Nano (2016) 7:6 DOI 10.1186/s12645-016-0018-5 REVIEW Open Access Trends in targeted prostate brachytherapy: from multiparametric MRI to nanomolecular radiosensitizers Alexandru Mihai Nicolae1, Niranjan Venugopal2 and Ananth Ravi1* *Correspondence: [email protected] Abstract 1 Odette Cancer Centre, The treatment of localized prostate cancer is expected to become a significant Sunnybrook Health Sciences Centre, 2075 Bayview Ave, problem in the next decade as an increasingly aging population becomes prone to Toronto, ON M4N3M5, developing the disease. Recent research into the biological nature of prostate cancer Canada has shown that large localized doses of radiation to the cancer offer excellent long- Full list of author information is available at the end of the term disease control. Brachytherapy, a form of localized radiation therapy, has been article shown to be one of the most effective methods for delivering high radiation doses to the cancer; however, recent evidence suggests that increasing the localized radiation dose without bound may cause unacceptable increases in long-term side effects. This review focuses on methods that have been proposed, or are already in clinical use, to safely escalate the dose of radiation within the prostate. The advent of multiparametric magnetic resonance imaging (mpMRI) to better identify and localize intraprostatic tumors, and nanomolecular radiosensitizers such as gold nanoparticles (GNPs), may be used synergistically to increase doses to cancerous tissue without the
    [Show full text]
  • Review of Outpatient Brachytherapy Medicare Payments to Carolinas Medical Center
    DEPARTMENT OF HEALTH & HUMAN SERVICES OFFICE OF INSPECTOR GENERAL Office of Audit Services, Region IV 61 Forsyth Street, SW, Suite 3T41 Atlanta, GA 30303 February 6, 2012 Report Number: A-04-11-06135 Ms. Suzanne Freeman Divisional President Carolinas Medical Center P.O. Box 32861 Charlotte, NC 28232-2861 Dear Ms. Freeman: Enclosed is the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), final report entitled Review of Outpatient Brachytherapy Medicare Payments to Carolinas Medical Center. We will forward a copy of this report to the HHS action official noted on the following page for review and any action deemed necessary. The HHS action official will make final determination as to actions taken on all matters reported. We request that you respond to this official within 30 days from the date of this letter. Your response should present any comments or additional information that you believe may have a bearing on the final determination. Section 8L of the Inspector General Act, 5 U.S.C. App., requires that OIG post its publicly available reports on the OIG Web site. Accordingly, this report will be posted at http://oig.hhs.gov. If you have any questions or comments about this report, please do not hesitate to call me, or contact Andrew Funtal, Audit Manager, at (404) 562-7762 or through email at [email protected]. Please refer to report number A-04-11-06135 in all correspondence. Sincerely, /Lori S. Pilcher/ Regional Inspector General for Audit Services Enclosure Page 2 – Ms. Suzanne Freeman Direct Reply to HHS Action Official: Nanette Foster Reilly Consortium Administrator Consortium for Financial Management & Fee for Service Operations Centers for Medicare & Medicaid Services 601 East 12th Street, Room 235 Kansas City, Missouri 64106 Department of Health and Human Services OFFICE OF INSPECTOR GENERAL REVIEW OF OUTPATIENT BRACHYTHERAPY MEDICARE PAYMENTS TO CAROLINAS MEDICAL CENTER Daniel R.
    [Show full text]
  • Radiation Quick Reference Guide Recommend Contacting Your State Fusion Center
    Domestic Nuclear Detection Office If you encounter something suspicious follow your specific local protocols. Radiation Quick Reference Guide Recommend contacting your state fusion center. DNDO is available 24/7 to assist at 1-877-DNDO-JAC / 1-877-363-6522 JAC Information Line 202-254-7179 Email: [email protected] Nuclear Concerns/ Threats 1. Nuclear Weapon - a device that releases nuclear energy in an ex- Isotopes of Concern for use in RDDs - with common uses plosive manner. Uses Highly Enriched Uranium (HEU) and/or 1. Cobalt-60 – cancer treatment, level/ Plutonium. density gauge, teletherapy, radiography, 2. Improvised Nuclear Device (IND) - a nuclear weapon fabricated food sterilization/irradiation, by a terrorist organization or rogue nation. brachytherapy 2. Iridium-192 – Radiography/non- destructive testing, flaw detection, brachy- therapy “cancer seed”, skin cancer Cobalt 60 sources Uranium “superficial” brachytherapy Plutonium 3. Uranium a. Uranium exists naturally in the earth’s crust. Of the different “isotopes” of uranium, U-235 is the one required to produce a Iridium sentinel and nuclear weapon. gamma camera b. Natural uranium contains a small amount of U-235 (<1%) which Cesium Seeds must be separated in complex extraction processes to create HEU. The predominant uranium isotope is U-238. 3. Cesium-137 - Gauge/level gauge, industrial radiography, brachyther- c. Highly Enriched Uranium (HEU) refers to uranium usable in weap- apy/teletherapy, well logging/density gauges ons due to its enrichment in U-235. 4. Strontium-90 – Radioisotope thermoelectric generator (RTG), fis- d. Approximately 25 kg of HEU is required for a nuclear weapon. sion product, industrial gauges, medical treatment e.
    [Show full text]
  • High Dose-Rate Brachytherapy of Localized Prostate Cancer Converts
    Open access Original research J Immunother Cancer: first published as 10.1136/jitc-2020-000792 on 24 June 2020. Downloaded from High dose- rate brachytherapy of localized prostate cancer converts tumors from cold to hot 1,2,3 1 1 1 Simon P Keam , Heloise Halse, Thu Nguyen, Minyu Wang , Nicolas Van Kooten Losio,1 Catherine Mitchell,4 Franco Caramia,3 David J Byrne,4 Sue Haupt,2,3 Georgina Ryland,4 Phillip K Darcy,1,2 Shahneen Sandhu,5 2,4 2,3 6 1,2 Piers Blombery, Ygal Haupt, Scott G Williams, Paul J Neeson To cite: Keam SP, Halse H, ABSTRACT organized immune infiltrates and signaling changes. Nguyen T, et al. High dose- rate Background Prostate cancer (PCa) has a profoundly Understanding and potentially harnessing these changes brachytherapy of localized immunosuppressive microenvironment and is commonly will have widespread implications for the future treatment prostate cancer converts tumors immune excluded with few infiltrative lymphocytes and of localized PCa, including rational use of combination from cold to hot. Journal for low levels of immune activation. High- dose radiation radio- immunotherapy. ImmunoTherapy of Cancer 2020;8:e000792. doi:10.1136/ has been demonstrated to stimulate the immune system jitc-2020-000792 in various human solid tumors. We hypothesized that localized radiation therapy, in the form of high dose- INTRODUCTION ► Additional material is rate brachytherapy (HDRBT), would overcome immune Standard curative- intent treatment options published online only. To view suppression in PCa. for localized prostate cancer (PCa) include please visit the journal online Methods To investigate whether HDRBT altered prostate radical prostatectomy or radiotherapy.1 (http:// dx.
    [Show full text]
  • The Supply of Medical Isotopes
    The Supply of Medical Isotopes AN ECONOMIC DIAGNOSIS AND POSSIBLE SOLUTIONS The Supply of Medical Isotopes AN ECONOMIC DIAGNOSIS AND POSSIBLE SOLUTIONS The Supply of Medical Isotopes AN ECONOMIC DIAGNOSIS AND POSSIBLE SOLUTIONS This work is published under the responsibility of the Secretary-General of the OECD. The opinions expressed and arguments employed herein do not necessarily reflect the official views of OECD member countries. This document, as well as any data and any map included herein, are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. Please cite this publication as: OECD/NEA (2019), The Supply of Medical Isotopes: An Economic Diagnosis and Possible Solutions, OECD Publishing, Paris, https://doi.org/10.1787/9b326195-en. ISBN 978-92-64-94550-0 (print) ISBN 978-92-64-62509-9 (pdf) The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law. Photo credits: Cover © Yok_onepiece/Shutterstock.com. Corrigenda to OECD publications may be found on line at: www.oecd.org/about/publishing/corrigenda.htm. © OECD 2019 You can copy, download or print OECD content for your own use, and you can include excerpts from OECD publications, databases and multimedia products in your own documents, presentations, blogs, websites and teaching materials, provided that suitable acknowledgement of OECD as source and copyright owner is given.
    [Show full text]
  • A Review of Rectal Toxicity Following Permanent Low Dose-Rate Prostate Brachytherapy and the Potential Value of Biodegradable Rectal Spacers
    Prostate Cancer and Prostatic Disease (2015) 18, 96–103 © 2015 Macmillan Publishers Limited All rights reserved 1365-7852/15 www.nature.com/pcan REVIEW A review of rectal toxicity following permanent low dose-rate prostate brachytherapy and the potential value of biodegradable rectal spacers ME Schutzer1, PF Orio2, MC Biagioli3, DA Asher4, H Lomas1 and D Moghanaki1,5 Permanent radioactive seed implantation provides highly effective treatment for prostate cancer that typically includes multidisciplinary collaboration between urologists and radiation oncologists. Low dose-rate (LDR) prostate brachytherapy offers excellent tumor control rates and has equivalent rates of rectal toxicity when compared with external beam radiotherapy. Owing to its proximity to the anterior rectal wall, a small portion of the rectum is often exposed to high doses of ionizing radiation from this procedure. Although rare, some patients develop transfusion-dependent rectal bleeding, ulcers or fistulas. These complications occasionally require permanent colostomy and thus can significantly impact a patient’s quality of life. Aside from proper technique, a promising strategy has emerged that can help avoid these complications. By injecting biodegradable materials behind Denonviller’s fascia, brachytherpists can increase the distance between the rectum and the radioactive sources to significantly decrease the rectal dose. This review summarizes the progress in this area and its applicability for use in combination with permanent LDR brachytherapy. Prostate Cancer and Prostatic Disease (2015) 18, 96–103; doi:10.1038/pcan.2015.4; published online 17 February 2015 A BRIEF HISTORY OF LOW DOSE-RATE PROSTATE demonstrated an 82% 8-year bPFS for 1444 patients treated with BRACHYTHERAPY radioactive seed implant for low-risk disease;4 (2) a series by Originally described in 1917, low dose-rate (LDR) prostate Taira et al.
    [Show full text]